Abstract P361: Health Behaviors, Healthcare Utilization and Social Determinants of Health Among Afro-Latin and Non-Hispanic Black Men at Risk for Hypertension: The CLIP Study
Authors: Milla E Arabadjian, Tanisha Green, Ligong Chen, Antoinette Schoenthaler, Olugbenga Ogedegbe, JOSEPH RAVENELL
Journal: Circulation (2024)

Background: Non-Hispanic Black (NHB) men experience cardiovascular disparities, including high prevalence of hypertension and high morbidity and mortality due to cardiovascular disease (CVD). Less is known about CVD risk among Afro-Latin (AL) men, who are an understudied population overall. The Hispanic/Latin population is the largest and fastest growing ethnic minority group in the United States, as well as one of the most heterogeneous. However, CVD in this population is often examined in aggregate, or by country of origin, and is most often compared to Non-Hispanic White individuals, not only limiting understanding of CVD risk but also potential avenues for intervention. Objective: To describe CVD risk, healthcare utilization and social determinants of health among a sample of AL and NHB men. Methods and Results: We present preliminary data from the Community-to-Clinic Linkage Program (CLIP) study, a community-based cluster randomized trial testing barbershop facilitation to prevent hypertension in normotensive Black men. The study is set in Staten Island (SI), New York City. Approximately 10% of SI residents identify as Black, of which ~ 90% live in 6 zip codes with the highest prevalence of hypertension in the borough. Within the cohort (N=243), AL men (N=88) and NHB men (N=155) had similar blood pressure, but AL men were younger and had lower BMI compared to NHB men, age mean (SD), 35.1 (11.8) years versus 39.2 (12.1) years, p=0.007, BMI 25.6 (4.2) versus 27.2 (5.2) BMI, p=0.01. While diet was similar, AL men had higher levels of weekly physical activity, 5662 (4927) minutes versus 3461 (2453) minutes among NHB men, p&lt;0.001. Both groups had a similar rate of smoking tobacco and there were no differences related to sleep quality or sleep duration. AL men were more likely to have seen a healthcare provider in the last 5 years compared to NHB men and used the emergency room for care more than NHB men, 70.5% versus 47.6%, p=0.02, and 20.4% versus 9.2%, p=0.02, respectively. More AL men delayed medical care because of costs in the last year than NHB men, 8.2% versus 2.3%, p=0.03. Fewer AL men reported having a primary care provider, 19.4% versus 29.3%, p=0.03 compared to NHB men. Both groups reported similar rates of depressive symptoms and social support, but NHB men had higher perceives stress (PSS-4 scores), 6.0 (2.9) versus 4.4 (3.4), p&lt;0.001 than AL men. More AL men were born abroad, 69.4% versus 96.6%, p&lt;0.001 than NHB men. Education attainment was similar between both groups; AL men were more likely to be employed full-time than NHB men, 57.1% versus 51.7%, p=0.04. Income data was limited as approximately a third of men declined to respond. Conclusion: Understanding CVD risk and patterns of healthcare utilization among Afro-Latin and Non-Hispanic Black men will help inform strategies for intervention to improve cardiovascular health and reduce CVD disparities.