Hypertension Experience of Foreign-Born West African Immigrant Women in the United States: Access to and Utilization of Health Services

Abstract

BackgroundHypertension is a major risk factor for cardiovascular disease and the leading cause of premature deaths in the United States. Hypertension is a commonly reported chronic disease in foreign-born-adult immigrants living in the United States, and psychosocial-cultural factors such as lack of health insurance and poor transportation services have been reported particularly among foreign-born immigrant women with hypertension and other chronic diseases. However, little is known about the socio-cultural factors that influence access to and utilization of hypertension health services in West-African-born immigrant women in the United States.MethodsThis study utilized a qualitative design with a phenomenological approach to interview a purposeful sample of fifteen West-African-born immigrant women that reported diagnosis of hypertension (12 with health insurance and 3 without health insurance) in the Washington District of Columbia Metropolitan area. The Patient Centered Access to Health Care Model guided the conceptual framework of the study. Thematic analysis was used to identify patterns and generate categories and themes.ResultsFive themes emerged from the analysis: Health Insurance Coverage, Frequency of Hypertension Care Visits, Interaction with HCP, Culturally Sensitive HCP, and HTN Self-Care Incentives. Eighty percent of participants had medical insurance and transportation services, but delayed seeking HTN care because their health care providers did not listen to their concerns or discuss their preferences before prescribing treatment. More than 60 percent of the women reported that clinicians did not listen to their concerns or provide culturally appropriate guidance during their visits.ConclusionsThese findings could be helpful for larger scale studies, or smaller comparative studies in other regions of the United States. Cultural competence training should be included in the continuing education curriculum of healthcare providers serving the West-African-born immigrant population.