ORIGINAL CONTRIBUTIONS |
Ethnicity, Education, and Blood Pressure in Cuba
1 Department of Public Health, Faculty of Medical Sciences, University Hospital "Dr. Gustavo Aldereguia Lima," Cienfuegos, Cuba
2 The Institute of Medical Sciences of Havana, Havana, Cuba
3 Department of Preventive Medicine and Epidemiology, Loyola University Medical School, Maywood, IL
Correspondence to Dr. Richard S. Cooper, Department of Preventive Medicine and Epidemiology, Loyola University Medical School, 2160 South First Avenue, Maywood, IL 60153 (e-mail: rcooper{at}lumc.edu).
The causes of variation in hypertension risk by ethnicity and educational level are not well understood. To gain further insight into this issue in a nonindustrialized country, a population-based sample of 1,667 persons aged 15–74 years was recruited in Cienfuegos, Cuba. In this 2001–2002 study, interviewers classified 29% of participants as Black or mulatto and 71% as White. Educational attainment was stratified at the median number of school years. Compared with White women, non-White women had higher blood pressures (3.0/1.7, systolic blood pressure/diastolic blood pressure) and a higher prevalence of hypertension (24%, 95% confidence interval: 20, 28 vs. 15%, 95% confidence interval: 12, 18). Among men, no differences in blood pressure were observed by ethnicity. Men with a lower level of education had a 14% lower risk of hypertension compared with men above the median. However, women with a lower level of education had a 24% increase in risk. The effect of education was equally strong among Whites alone and when occupation was used for stratification. No variation was observed for body mass index or self-reported health behaviors by ethnicity or education. The narrower ethnic gradient in hypertension prevalence than seen in North America and the gender-specific social status effect, in the context of relatively equal living conditions, suggest that the influence of psychosocial stressors may be specific to cultural contexts.
blood pressure; body mass index; Cuba; education; ethnic groups; health behavior; hypertension; stress
Abbreviations: CI, confidence interval; DBP, diastolic blood pressure; SBP, systolic blood pressure
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