Abstract P651: Assessing the Pathway Between Health Care Utilization and Hypertensive Outcomes Among Young Adult African American Medicaid Beneficiaries in Delaware

Abstract

Introduction: African Americans have been studied to underutilize medical care in comparison to other groups due to a variety of factors, including lack of access and medical mistrust, both attributable long-standing systemic oppression. Thus, African Americans bare a disproportionate burden of chronic conditions, including hypertension, which is more than two times more prevalent among African Americans in comparison to other groups. To date, the health care utilization behaviors of African American young adults, ages 18-30, are understudied. Addressing this relationship in a young sample may be informative in fostering long-term improvement of health outcomes for African Americans. Question: Among African Americans aged 18-30. is there an association between hypertension diagnosis and recent receipt of a general adult medical exam? Methods: We conducted a cross-sectional case control study using data from a sample of African American Medicaid recipients living in Delaware, aged 18-30. Following an assessment of demographic characteristics, we performed logistic regression adjusted for gender and zip code to investigate the association between hypertension diagnosis and receipt of a general adult medical exam within the study period. Results: Among patients aged 18-30, those with hypertension (n=2,506) had 1.4 times the odds of reporting to have received a general adult medical exam during the study period when compared to those without hypertension (n=24526; p<.0001). The difference between the mean number of visits between strata (.379 vs. .302) is statistically significant (p<.0001). Conclusion: Our findings suggest that young adult African American patients living with hypertension are more likely to have a general adult medical exam during the study period than clients of the same age group without hypertension. We believe this may implicate that those with poorer health tend to seek care more often, though further research is needed to better understand motivations for seeking care. Improved understanding of the pathway between health care utilization and hypertension through a younger lens will be critical in targeting self-advocacy programs that address aversion to care-seeking behaviors for generations to come.