Financial responsibility, financial context, and ambulatory blood pressure in early middle-aged African-American women

Tené T Lewis; Rachel Parker; Christy L Erving; Shivika Udaipuria; Raphiel J Murden; Nicole D Fields; Bianca Booker; Reneé H Moore; Viola Vaccarino

doi:10.1016/j.socscimed.2024.116699

Financial responsibility, financial context, and ambulatory blood pressure in early middle-aged African-American women

Soc Sci Med. 2024 Mar:345:116699. doi: 10.1016/j.socscimed.2024.116699. Epub 2024 Feb 17.

Authors

Tené T Lewis¹, Rachel Parker², Christy L Erving³, Shivika Udaipuria⁴, Raphiel J Murden², Nicole D Fields⁴, Bianca Booker⁴, Reneé H Moore⁵, Viola Vaccarino⁶

Affiliations

¹ Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA. Electronic address: tene.t.lewis@emory.edu.
² Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
³ Department of Sociology, The University of Texas at Austin, Austin, TX, USA.
⁴ Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
⁵ Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
⁶ Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Epidemiology and Biostatistics, Drexel University, Dornsife School of Public Health, Philadelphia, PA, USA.

PMID: 38412624
PMCID: PMC11014723 (available on 2025-03-01)
DOI: 10.1016/j.socscimed.2024.116699

Abstract

Background: African-American women have excess rates of elevated blood pressure (BP) and hypertension compared to women of all other racial/ethnic backgrounds. Several researchers have speculated that race and gender-related socioeconomic status (SES) stressors might play a role.

Objective: To examine the association between a novel SES-related stressor highly salient among African-American women, financial responsibility for one's household, and 48-h ambulatory BP. We further examined whether aspects related to African-American women's financial context (e.g., single parenthood, household income, marital status) played a role.

Methods: Participants were N = 345 employed, healthy African-American women aged 30-46 from diverse SES backgrounds who underwent 48-h ambulatory BP monitoring. Linear regression analyses were conducted to examine associations between self-reported financial responsibility and daytime and nighttime BP, adjusting for age, SES and other sociodemographics, cardiovascular risk factors, financial strain and depressive symptoms. Interactions between financial responsibility and single parenthood, household income, and marital/partnered status were tested.

Results: In age-adjusted analyses, reporting financial responsibility was associated with higher daytime systolic (β = 4.42, S.E. = 1.36, p = 0.0013), and diastolic (β = 2.82, S.E. = 0.98, p = 0.004) BP. Associations persisted in fully adjusted models. Significant associations were also observed for nighttime systolic and diastolic BP. There were no significant interactions with single parenthood, household income, nor marital/partnered status.

Conclusion: Having primary responsibility for one's household may be an important driver of BP in early middle-aged African-American women, independent of SES, financial strain, and across a range of financial contexts. Future studies examining prospective associations are needed, and policy interventions targeting structural factors contributing to financial responsibility in African-American women may be warranted.

Keywords: African-American; Financial stress; Hypertension; Social Determinants of health.

MeSH terms

Black or African American*
Blood Pressure / physiology
Blood Pressure Monitoring, Ambulatory
Female
Humans
Hypertension* / diagnosis
Hypertension* / epidemiology
Middle Aged
Social Class

Abstract

MeSH terms

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