Unmet needs for hypertension care cascade in older adults and socioeconomic disparities: evidence from five national cohorts
摘要
Adults aged 50 years and older are more likely to experience unmet health care needs for hypertension, particularly given the existence of socioeconomic disparities in its diagnosis, treatment, and control. This study aims to assess unmet health care needs for hypertension following a care cascade among adults aged 50 years and older from both high-income countries and low- and middle-income countries (LMICs).
MethodsWe used data from five national cohorts to estimate the extent of unmet health care needs for hypertension diagnosis, treatment, and control in the US, the UK, China, Mexico, and India, and to examine the socioeconomic equity and influencing factors.
ResultsWe included 98,510 participants recruited between 2013 and 2018. The overall level of unmet health care needs for hypertension reached 73.42%, with Mexico having the highest level at 79.48% and the US having the lowest at 45.43%. Among all types of unmet needs, diagnostic gaps were the largest (46.7%), followed by treatment (22.9%) and control (30.5%). Males (RRR = 1.59), rural residents (RRR = 1.68), those with less than lower secondary educational level (RRR = 1.51), low-income level (RRR = 1.31), no public health insurance (RRR = 1.33), engaged in paid work (RRR = 1.60), and live alone (RRR = 1.17) were more likely to suffer unmet diagnostic needs. Similar patterns were found regarding the unmet treatment and control needs.
ConclusionA substantial proportion of adults aged 50 years and older suffer from unmet needs in hypertension care, particularly those in LMICs. Populations with low socioeconomic status are faced with more serious unmet health care needs. These findings suggest that policymakers should consider targeted strategies to address the identified deficiencies in chronic disease management.