ArticleJournal of health, population, and nutrition2025
Residential inequalities in hypertension medication use: a multivariate non-linear decomposition analysis.
Article in Journal of health, population, and nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundGeographic disparities between urban and rural areas can impact healthcare access due to differences in infrastructure, availability of healthcare providers, and economic conditions. Investigating these disparities is essential for identifying gaps in treatment access and informing policies to improve medication adherence and health outcomes. This study aims to examine the prevalence of hypertension medication use among adults in Cape Verde and assess residential inequalities in adherence to medication use.
methodsThe study was based on the observations of 468 adults (18–69 years) living with hypertension who participated in the 2020 WHO STEPS. Descriptive analysis was done to assess the distribution of medication use across the participants’ characteristics. Two set of binary logistic regression were performed to determine the associated factors of medication use. Concentration index was used to assess the level of residential inequalities while a multivariate non-linear decomposition was done to identify factors that contributed to residential inequalities.
resultsOverall, less than half of persons living with hypertension in Cape Verde (40.9% [34.3–47.8]) take their medication. Urban residents were more likely to use medication than their rural counterparts [AOR = 1.88; 95%CI: 1.21–2.94]. Women were more likely to use medication than men [AOR = 1.70; 95%CI: 1.04–2.80]. Individuals who had diabetes [AOR = 2.12; 95%CI: 1.00-4.49] or were overweight/obese [AOR = 1.78; 95%CI: 1.09–2.90] were more likely than those without such co-morbidities to use medication. Persons with hypertension who consumed < 4 servings of fruits per day had lower odds of taking blood pressure medication [AOR = 0.52; 95%CI: 0.30–0.93]. The findings indicate that the rural-urban differences in characteristics explain only a small portion (8.78%) of the gap in hypertension medication use. Only age contributed significantly to the observed residential inequalities (p < 0.001, 2.75%).
conclusionThere is a moderate level of residential inequality in medication use among persons living with hypertension. This inequality favors urban residents. Any interventions to improve antihypertensive medication uptake must prioritize rural residents.
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