Healthcare and Social Barriers Affecting Black Men's Treatment for Hypertension and Chronic Diseases

Healthcare Barriers Affecting Black Male Patients

Black men in America seem to face a higher prevalence of hypertension than other ethnicities and there is no clear reason. Black men in America that are diagnosed with hypertension face increased mortality, morbidity, and end-stage organ damage at a far higher rate than other ethnicities and black women. With varying reasons of why black men suffer more than others facing this common chronic disease. There is a deeper truth than what the statistics show. The statistics should incorporate healthcare-initiated barriers that may affect treatment and outcomes for adult black men diagnosed with chronic diseases. The statistics don’t cover the distrust and disconnect that black men feel for the healthcare system in the United States. With a history of unethical practices preformed on black men in this country it is fair to questioned the treatment of this chronic condition. 
The purpose of this review is to find out “What are healthcare-initiated and social barriers that may affect treatment and outcomes for adult black men diagnosed with hypertension and other chronic diseases?”. 
Search method: PubMed – Hypertension black men barriers Last 10 years, PubMed 
Black Hypertension
When it comes to hypertension, black men seem to be disproportionately affected by healthcare disparities. There are a ton of reason why these barriers affect the treatment of hypertension in black men, but let’s cover the major topics/Issues. 
One major issue is medication adherence in the black community. According to The World Health Organization, five interacting dimensions affecting medication non-adherence: social/economic factors, therapy-related factors, patient-related factors, condition-related factors, and health system/health care team-related factors. These factors have to be addressed in order to increase the percentage of medication adherence to improve patient outcomes.  Also, while trying to use interventions for the disparities being understanding to the patient’s culture and beliefs. Out the five factors socioeconomics is the biggest contributor to nonadherence for black men. Socioeconomics covers many topics like; poverty, illiteracy, unemployment, lack of social support networks, unstable living conditions, greater distance from treatment centers, higher out-of-pocket cost of medications and care, lack of transportation, cultural beliefs reflecting mistrust in the health care system, family dysfunction, patient demographic characteristics, levels of education, and literacy. Yes, all these issues for socioeconomics are reasons for medication nonadherence, but distrust of the is one of the most common themes when surveying black men.   According to (Gamble, 1997) the Tuskegee Syphilis Study is the most influential reason why many African Americans distrust the institutions of medicine and public health.  (Sim, 2021) “Racial health disparities have been long standing, as evidenced by the landmark report from the Institute of Medicine (IOM) in 2003. Minorities were documented to receive fewer procedures and poorer quality medical care than the majority, even after controlling for confounders. The severity of racial health inequities is further reflected in the COVID-19 pandemic where racism in healthcare has been purported to be a significant driving force of the disproportionately high mortality rates in minorities”. This study and many more documented mistreatments of minorities mainly black people in the unites sates is one of the top main barriers in why black men don’t follow treatment plans. Even today, new reports about how black women have 4 times higher chance of dying from complications of pregnancy than white women with no clear reason why. With stories like these it seems black men should be cautions about the diagnosis and treatment plan giving to them by a health physician. 
The next issues in the socioeconomic realm of problems is poverty. Poverty causes a cascade of barriers that could cause barriers to black men treatment. With poverty, comes unhealthy eating. Healthy food cost more that process foods. Process food normally has a greater amount of sodium to preserve them. According to (Will,2002), which talks about how salt sensitivity is higher in black people than in white people. Their hypothesis suggest that TGF-beta was found to be hyper expressed in black patients with hypertension. Salt sensitivity is defined as a change in blood pressure in response to changes in salt and water homeostasis according to (Svetkey, 2014). She found in 73% of hypertensive and 36% of normotensive blacks, it is generally considered a hallmark feature of hypertension in black people. If this is the case and  true, why isn’t this screened for during early childhood? Well, upon further reading Svetkey study she states “it is unclear to what extent these traits represent salt sensitivity in its traditional meaning. Furthermore, it is unclear to what extent these observations in predominantly white populations apply to salt sensitivity in blacks.” These studies and others like them all have the same conclusion, the cause is unknown. The higher prevalence of hypertension in blacks living in the United States instead of Africa demonstrates that environmental and behavioral characteristics are the more likely reasons for the higher prevalence in blacks living in the United States.