International Journal of Epidemiology, Vol 24, S79-S84, Copyright © 1995 by International Epidemiological Association
M Morgan
Afro-Caribbeans are the second largest ethnic minority in the UK and are
concentrated in some inner London areas where they comprise over 12% of the
population. Standardized mortality ratios for stroke are relatively high
among the Afro-Caribbeans, for whom the control of high blood pressure is
thus of particular significance. Semi-structured interviews were conducted
with matched groups of 'white' and Afro- Caribbean hypertensive patients
attending 15 general practices in an inner London area to examine their
beliefs and practices regarding the prescribed drugs. Adherence was high
among 'white' patients, but less than half the Afro-Caribbeans took the
drugs regularly as prescribed with many having poorly controlled blood
pressures. Non-adherence was influenced by traditional cultural beliefs and
practices which often strengthened concerns about the long-term harmful
effects of drugs and provided an alternative resource in terms of herbal
remedies. There was also evidence of a cultural gulf and lack of
communication between Afro- Caribbean patients and their general
practitioners, thus reducing the effectiveness of this preventive strategy.
ARTICLES
The significance of ethnicity for health promotion: patients' use of anti-hypertensive drugs in inner London
Department of Public Health Medicine, UMDS, London, UK.
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