The Association Between State Characteristics and Latinx People's Treated Hypertension in Established and New Latinx Destination States: A Multilevel Analysis.

Creator(s)

Adriana Maldonado
Helena Laroche, Children's Mercy HospitalFollow
Daniel K. Sewell
Rima Afifi
Richard M. Hoffman
Barbara Baquero
Paul A. Gilbert

Document Type

Article

Publication Date

4-2024

Identifier

DOI: 10.1097/FCH.0000000000000393

Abstract

This study sought to quantify the contributions of state-level factors including income inequality, state's legislature political control, and Medicaid expansion in new and established Latinx destination states on Latinx individuals' treated hypertension. Mixed-effects logistic regression analyses were conducted to analyze 2017 Behavioral Risk Factor Surveillance System data from 7524 Latinx adults nested within 39 states. Overall, 70% reported being pharmacologically treated for hypertension, and 66% resided in established destination states. Compared with Latinx people in established destination states, Latinx people in new destinations had lower odds of having treated hypertension (odds ratio [OR] = 0.72, 95% CI = 0.54-0.95). Within established Latinx destinations, the odds of treated hypertension were lower in states where legislatures expanded Medicaid than in states that did not expand Medicaid (OR = 0.84, 95% CI = 0.79-0.89). However, after controlling for the effects of individual-level factors, this association was no longer statistically significant. In new Latinx destination states, Medicaid expansion, legislatures' political control, and income inequality were not associated with treated hypertension. The study results highlight the importance of considering both individual- and state-level factors, as the interplay of such factors could hinder the successful implementation of cardiovascular risk reduction interventions.

Journal Title

Family & community health

Volume

47

Issue

2

First Page

151

Last Page

166

MeSH Keywords

Adult; United States; Humans; Multilevel Analysis; Medicaid; Hypertension; Hispanic or Latino

Keywords

Multilevel Analysis; Medicaid; Hypertension; Hispanic or Latino

Recommended Citation

Maldonado A, Laroche HH, Sewell DK, et al. The Association Between State Characteristics and Latinx People's Treated Hypertension in Established and New Latinx Destination States: A Multilevel Analysis. Fam Community Health. 2024;47(2):151-166. doi:10.1097/FCH.0000000000000393