Abstract P138: Private School Attendance and Later Life Hypertension

Abstract

Introduction: Black Americans have the highest prevalence of hypertension in the United States (US). Higher educational attainment has been found to have an inverse association with hypertension, yet research examining the association between hypertension and components of education not captured by quantity of education, such as type of school attended, private vs. public, has been limited. The positive relationship between private school attendance and academic achievement, with effects particularly robust among Black Americans, suggests a potential role for private school attendance as a protective factor in hypertension. Hypothesis: Private school attendance compared with public school attendance is hypothesized to be associated with a lower prevalence of hypertension among African American and Afro-Caribbean men and women in the United States. Methods: Multiple logistic regression models were used to examine type of school attended, private vs. public, and its independent association between hypertension among African American (N = 2693) and Afro-Caribbean (N = 1308) men and women, 18 years and older, in the National Survey of American Life (2001-2003). Odds ratios (OR) of the association between type of school attended and adult hypertension were estimated after adjusting for age, socioeconomic factors, health and lifestyle measures within the models. Adult socioeconomic factors included marital status, education, occupation, home ownership and poverty status. Adult health and lifestyle covariates included obesity, diabetes, smoking, alcohol use and physical activity. Results: Private school attendance was a risk factor for hypertension among African American men; age-adjusted OR = 2.11; 95%CI: (1.07, 4.15). Conversely, private school attendance was a protective factor for Afro-Caribbean men; age-adjusted OR = 0.34; 95%CI: (0.13, 0.89). After adjusting for adult socioeconomic, health and lifestyle factors, the two-fold higher odds of hypertension compared to those who attended public schools remained among African American men who attended private schools; adjusted OR = 2.11; 95%CI: (0.97, 4.60). After covariate adjustment, private school attendance remained a statistically significant protective factor for Afro-Caribbean men; those who attended private schools had 68% decreased odds of hypertension compared to those men who attended public schools, adjusted OR = 0.32; 95%CI: (0.11, 0.94). No association between hypertension and school-type was found for either African American or Afro-Caribbean women. Conclusions: These findings suggest that type of school attended is another dimension of education relevant for the cardiovascular health of African American and Afro-Caribbean men. Additionally, it exerts a differential effect on hypertension by ethnicity.