Equalizing Health Care

By Jane Farrell

Hypertension, or high blood pressure, affects almost half of all people in the U.S. and can lead to serious health issues, including heart attack, stroke and kidney problems. Monitoring your blood pressure levels regularly is a key part of managing it, and the American Heart Association (AHA), with support from Elevance Health Foundation, is working to ensure more people have access to the tools needed to check their blood pressure at home.

“As high blood pressure disproportionately affects Black, Hispanic and Indigenous populations in the U.S., the American Heart Association continues its commitment to improve health equity nationwide, we strive to ensure that everyone has access to resources for a healthier life,” said AHA volunteer president Michelle A. Albert, M.D., M.P.H., FAHA, the Walter A. Haas-Lucie Stern endowed chair in cardiology, professor of medicine and admissions dean at University of California San Francisco School of Medicine. “We appreciate the support from Elevance Health Foundation, which enables us to work in the communities where the need is greatest.”

Acccording to an AHA news release, a recent poll by the Association was designed to evaluate patient perceptions and barriers to blood pressure management in the home setting. The survey participants—patients with high blood pressure at clinics in under-resourced areas throughout the U.S.—were provided with blood pressure kits to monitor their blood pressure at home as part of the Building Healthier, Safer Communities Together initiative supported by Elevance .More than three quarters (88%) of the participants said that they planned to check their blood pressure levels at least once daily, and over half of the respondents (64%) said they believe that monitoring their blood pressure at home will help to improve their overall health.

The program is a community-based initiative focused on blood pressure control in medically under-resourced communities and is one component of a nationwide project with Federally Qualified Health Centers (FQHCs) and other community clinics to facilitate and provide health education, guidance and resources to patients.

“Nearly half of all Americans have high blood pressure, which is why implementing interventions that target health measures – such as increased awareness and management of blood pressure – are crucial to not only improving the health of people living in historically under-resourced communities, but advancing equity for all,” said Shantanu Agrawal, M.D., chief health officer at Elevance Health. “Through this initiative, more than 3,500 patient care kits are in the hands of people at the highest risk, allowing them to monitor their blood pressure at home.”

According to research, community health workers can make a difference in improving patients’ access to care and treatment for health concerns such as high blood pressure. Community health workers can aid their patients and communities in various roles beyond just patient medical care, including providing health education, linking people with social services, and improving overall patient-health professional communication.

Communication is important, according to many of the survey responses. When patients were asked what could help them monitor their blood pressure at home, 38% replied that regular in-person consultations with a doctor or a nurse would be helpful, and 26% responded that more opportunities for education on blood pressure and hypertension would be helpful.

Adult patients from 11 clinics in nine markets throughout the U.S. who were diagnosed with high blood pressure and received a self-monitoring blood pressure kit were invited to participate in the survey. The survey was planned to identify gaps in knowledge of patients encouraged to regularly monitor their blood pressure at home, and is part of the Building Healthier, Safer Communities Together (BHSCT) program. Through the BHSCT initiative, the American Heart Association provided primary healthcare professionals with 350 patient care kits in 16 under-resourced target communities, Baton Rouge, La., New Orleans, La., Houston, Atlanta, Ga., Des Moines, Nashville, Tenn., Newport, Tenn., Los Angeles, Calif., Seattle, Wash., St. Louis, Mo., New York, N.Y., Indianapolis, Ind., Miami, Fla. and Cincinnati, Ohio, to distribute to their high-risk patients in support of remote blood pressure monitoring. The purpose of this evaluation is to use survey-based data collection to assess participant characteristics, perceptions and barriers to blood pressure management. This evaluation will inform the program for the next two years.

The program is a community-based initiative focused on blood pressure control in medically under-resourced communities and is supported by Elevance. Surveys were provided in both English and Spanish, and participants had the option to complete the 18-question survey in electronic form on a tablet during a clinic visit, or in a paper format. Data was collected between August 2021 and June 2022 and analyzed by the Evaluation Team in the Qualtrics system on behalf of the AHA. A total of 317 participants attempted the survey, 80% of whom were age 45 and older. Most of the responses received were from the electronic version of the survey (64%).[7] The majority of respondents identified as female (55%), aged 45-64 (59%), and as being of Hispanic, Latino, or Spanish origin (58%).