SOCIOECONOMIC POSITION, GENDER AND HYPERTENSION IN A RURAL CANADIAN POPULATION
Date
2015-01-16
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
ORCID
Type
Degree Level
Masters
Abstract
Background: High blood pressure is the leading risk factor for disease burden worldwide,
contributing to more than 9 million deaths each year. Some research suggests that the
prevalence of hypertension increases as individual/household socioeconomic position (SEP)
decreases. The results of multilevel studies also suggest an association between poorer
neighborhood socioeconomic circumstances and hypertension. Further, at both the
individual/household- and area-level, high blood pressure may be more strongly related to SEP
among women than men. Most research, however, has been restricted to urban populations.
There has not been much research which examines risk factors for hypertension in rural Canada
and, in particular, socioeconomic risk factors.
Objectives: To examine the relationship between individual/household- and area- level
socioeconomic circumstances, gender, and high blood pressure in a rural Saskatchewan
population.
Methods: There were two data sources for this study. Individual/household-level data
were from the Saskatchewan Rural Health Study (SRHS). Analyses focused on adults (n=8,261)
who completed the cross-sectional baseline questionnaire. Census subdivisions were used to link
SRHS data with area-level data from the 2006 Canadian census. The dependent variable was
self-reported diagnosed high blood pressure. The primary independent variables were gender and
four measures of socioeconomic circumstances: household income, educational attainment, arealevel
material deprivation, and area-level social deprivation. Principal components analysis was
used to derive the area-level measures of deprivation. Multilevel logistic regression was the
primary method of analysis.
Results: Four main findings emerged: 1) low educational attainment was associated with
a greater odds of high blood pressure; 2) the relationship between low household income and
high blood pressure was more pronounced among women than men; 3) the relationship between
higher area-level social deprivation and high blood pressure was more pronounced among men
than women; and 4) area-level material deprivation was not associated with high blood pressure.
iii
Conclusion: Study results revealed complex relationships between SEP, gender, and high
blood pressure in this rural Saskatchewan population. Future research applying a longitudinal
design is needed to advance understanding of the relationship between SEP and incident
hypertension in rural Canada, including the identification of vulnerable subgroups. Also needed
is research examining the factors which explain (i.e. mediate) associations between SEP and
hypertension in rural settings, particularly at the area-level.
Description
Keywords
Socioeconomic position, gender, hypertension, rural, multilevel, PCA, deprivation
Citation
Degree
Master of Science (M.Sc.)
Department
Community Health and Epidemiology
Program
Community and Population Health Science