An Examination of the Relationship Between Discrimination, Depression, and Hypertension in Native Hawaiians
An Examination of the Relationship Between Discrimination, Depression, and Hypertension in Native Hawaiians
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DOI：
10.1037/aap0000151
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发表时间：
2019-09-01
影响因子：
1.5
通讯作者：
Kaholokula, Joseph Keawe 'Aimoku
中科院分区：
文献类型：
--
作者：
Ing, Claire Townsend;Antonio, Mapuana;Kaholokula, Joseph Keawe 'Aimoku
夏威夷原住民承受着不成比例的高血压负担。歧视和抑郁是潜在的高血压危险因素。虽然歧视和抑郁症之间的关系已经确立，但这些因素如何影响土著居民的高血压风险仍然未知。我们研究了歧视，抑郁症和高血压之间的关系在成年夏威夷土著人。我们假设，更高频率的感知歧视和更高频率的抑郁症状会独立增加患高血压的可能性。调查邮寄给居住在5个夏威夷家园的540名成年夏威夷土著人。这些调查测量了高血压状况、社会人口因素（年龄、性别）。收入和就业状况），身体质量指数，身体活动频率，吸烟，夏威夷文化归属，美国文化归属，感知歧视和抑郁症状。受访者（n = 171; M-年龄= 57岁）大多为女性（71%），54%报告患有高血压。Logistic回归模型包括知觉歧视、抑郁、身体质量指数、剧烈体育活动频率、夏威夷文化归属。和社会人口变量。该模型显示，夏威夷文化归属和歧视显着相关的高血压状态。抑郁与高血压状态无关。交互分析发现，对于夏威夷文化背景较低的人来说，频繁感知的歧视与高血压的发病率较低显著相关。感知歧视与高血压状况之间的负相关与假设相反。然而，这种相互作用表明，这种关系只适用于文化联系较少的个体。这些结果强调了高血压决定因素的多样性，并可能对夏威夷土著人高血压的治疗具有临床意义。
Native Hawaiians bear a disproportionate burden of hypertension. Discrimination and depression are potential hypertension risk factors. Although the relationship between discrimination and depression is well established, how these factors affect hypertension risk in indigenous populations remains unknown. We examined the relationship between discrimination, depression, and hypertension in adult Native Hawaiians. We hypothesized that greater frequency of perceived discrimination and greater frequency of depressive symptoms would independently increase the likelihood of having hypertension. Surveys were mailed to 540 adult Native Hawaiians residing on 5 Hawaiian homesteads. The surveys measured hypertension status, sociodemographic factors (age, sex. income, and employment status), body mass index, physical activity frequency, smoking, Hawaiian cultural affiliation, American cultural affiliation, perceived discrimination, and depressive symptoms. Respondents (n = 171; M-age = 57 years) were mostly female (71%), and 54% reported having hypertension. The logistic regression model included perceived discrimination, depression, body mass index, frequency of vigorous physical activity, Hawaiian cultural affiliation. and sociodemographic variables. The model showed that Hawaiian cultural affiliation and discrimination were significantly related to hypertension status. Depression was not related to hypertension status. Interaction analysis found that for individuals with lower Hawaiian cultural affiliation, frequent perceived discrimination was significantly associated with lower odds of having hypertension. The negative association between perceived discrimination and hypertension status was opposite to that hypothesized. However, the interaction suggests this relationship holds only for less culturally affiliated individuals. These results underscore the varied nature of hypertension determinants and may have clinical implications for the treatment of hypertension in Native Hawaiians.