Risk Factors and Public Assistance Role in Hypertension among Homeless Population: A Cohort Study

Abstract

The Homeless population is the most socioeconomic underprivileged community in the United States. Cardiovascular complications are one of the leading causes of death among homeless individuals. This study highlights the major risk factors of hypertension among the homeless community in the Orlando metropolitan area, in order to provide solutions and to modify associated risk factors. Adult homeless individuals (N=167) were randomly selected during daily lunch shares at St. George Orthodox Church, Orlando Florida. Each consented participant completed a survey with inquiries about demographic, lifestyle and hypertension related risk factors. Blood pressure was measured twice using an automatic Welch Allyn Connex ProBP 2400 digital device and the readings average was calculated. The Body Mass Index (BMI) was also calculated according to the World Health Organization (WHO) criteria. Average age of participants was 42.3 ± 11 years, and 83% were men. The overall prevalence of hypertension among participants was 52% (87 out of 167). The prevalence of hypertension among individuals who reported to be homeless over one year was 73% (38 out of 52), compared to only 51.3% among those with less than one year. Among diabetic homeless, 70% suffers from hypertension. The prevalence of hypertension among smokers was 51% (48 out of 95), while hypertension according to BMI group was significantly higher in both overweight and obese groups compared to individuals with normal BMI. Hypertension was significantly prevalent among homeless receiving no assistance (75.67%) compared to those receiving both financial and social assistance (47.61%). However, financial assistance had a major effect on lowering hypertension prevalence in comparison to social assistance (58.62% and 74.41%, respectively). In conclusion, hypertension is prevalent among Orlando homeless cohort and it has surpassed the national average. Clearly, social and financial services seem to lower hypertension prevalence among homeless individuals receiving benefits. The outcome of the study supports data from other countries offering affordable and accessible health care services, and certainly, it renews the call for more resources to help the homeless communities.