Abstract 14215: Higher Social Vulnerability is Associated With Lower Self-Care Monitoring in African Immigrants With Chronic Disease

Abstract

Background: Self-care is important in chronic illness management. While known that social determinants of health or social vulnerability (SV) influence health outcomes, little is known about the influence of SV on self-care and less is known about how SV influences self-care among African immigrants with chronic Cardiovascular disease (CVD). Therefore, we examined the relationship between individual-level SV and self-care in this population. Method: Self-identified African immigrants with symptomatic chronic CVD, over age 35 years, who spoke and understood English were enrolled in this descriptive, cross-sectional study (n=128). Individual SV scores were calculated based on gender, marital status, education, English proficiency (speaking and understanding), race, income, employment, living condition, immigration status, health insurance, and healthcare access; possible SV 0-12. Higher scores, higher social vulnerability. Self Care of Chronic Illness Inventory measured self-care maintenance, monitoring, and management (scores standardized 0-100, ≥70 adequate self-care). Multivariable linear regression was used to assess the association of SV with self-care, adjusting for age and duration of US residency. Results: The sample was mostly older adults (56±11 years), 68% men, 70% married, 82% college educated, 89% living with family or others, with a long duration of residency (16±11 years). Most common illnesses were hypertension (48%) and/or diabetes (20%). Self-care scores were adequate (maintenance=78.7, monitoring=79.3, management=73.9). SV score (3.49±2.03). Higher SV was associated with lower self-care monitoring (p=0.04) but not with self-care maintenance or management. Conclusion: Self-care monitoring was the only dimension of self-care associated with SV. African immigrants who feel more socially vulnerable may focus on monitoring to avoid needing acute care. Culturally tailored interventions focused on self-care monitoring may help this population follow a reliable method in detecting significant changes in signs and symptoms.