Text Connection




Thearticle “Invited Commentary: Fundamental Causes, Social Context,and Modifiable Risk Factors in the Racial/Ethnic Inequalities inBlood Pressure and Hypertension” was written by Margaret Hicken andpublished in the American Journal of Epidemiology in 2015. Thearticle addresses the issue of ethnic inequalities in hypertensionand blood pressure.

WhatI agree with

Thereare three major factors presented in the article that I agree with.First, I agree with the basic fact presented in the articleindicating that there exists a significant ethnic disparity in highblood pressure as well as hypertension. Secondly, I agree with thefactors that the author identified as the major risk factors for twoconditions, namely hypertension and blood pressure. These riskfactors include alcohol use, overweight, smoking, sodium intake, andinequality in the distribution of different types of resources.

Howthe reading changed my perspective

Ihave always thought that smoking, wrong BMI, alcohol use, and sodiumintakes are the fundamental causes of hypertension, but the authorconsiders these risk factors as intermediaries. The article providesa new perspective indicating that inequalities in the distribution ofdifferent types of resources are the primary cause of hypertension.This is the reason why the author states that addressing theintermediary causes of hypertension while failing to resolve theissue of inequalities in the distribution of resources results inminimum change no change, or makes the disparity worse.

Howthe article relates to a current public health concern

Thearticle addresses one of the most critical health issues,hypertension, in the U.S. given that over 77 million Americans aresuffering from hypertension (American Heart Association, 2013).However, the majority of those affected are the people of color,especially the black Americans. Therefore, racial disparity in theprevalence of hypertension is real and of a major concern.

Inconclusion, the article addresses a significant health issue, whichis the ethnic disparity in the prevalence of hypertension. The authoremphasizes that resolving the issue of inequality in the distributionof different types of resources is the only sustainable solution.


AmericanHeart Association (2013). Statisticalfact sheet: High blood pressure.Dallas, TX: American Heart Association.

Hicken,T. (2015). Invited commentary: Fundamental causes, social context,and modifiable risk factors in the racial/ethnic inequalities inblood pressure and hypertension. AmericanJournal of Epidemiology,182 (4), 354-357.


Thearticle “Racial/Ethnic Disparities in Hypertension Prevalence:Reconsidering the Role of Chronic Stress” was written by MargaretHicken, Hedwig Lee, Jeffrey Morenoff, James House, and DavidWilliams. The article was published in the American Journal of PublicHealth in 2014. The main theme addressed by the authors is the racialdisparity in the prevalence of hypertension.

WhatI agree with

Thereare two factors that I agree with in the article. First, I agree withthe author’s idea that ethnicity and hypertension are positivelyrelated. This relationship is correct since it has been supported byempirical evidence. Secondly, I agree with the authors that, althoughthe prevalence of hypertension is higher among the people of color,the black Americans are affected mother than other groups.

Howthe article differs from what I already know

Theauthors identified that racial disparity in the prevalence ofhypertension persists even after preventive measures (includingfinding solutions to socio-economic risk factors, smoking, wrong BMI,alcohol use, and consumption of sodium) are implemented. From thebasic knowledge I had before reading the article, resolving thesocio-economic challenges can reduce this disparity. The differenceexists because the authors used the empirical evidence shown by thelatest research articles indicating that there could be some unknownrisk factors that hinder the process of reducing the disparity.

Howthe reading impacts the community

Thereading impacts the community by providing useful information aboutthe current research findings. The article informs that communitythat resolving the conventional issues (such as reducing smoking,drinking, and other common risk factors) is not a viable solution tothe ethnic disparity in the prevalence of hypertension. This meansthat the community will continue experiencing this disparity untilresearchers identify what the authors of the article referred to asunknown risk factors. Although these findings may subject thecommunity to a desperate situation, the stakeholders will avoidunnecessary investment in resolving traditional risk factors.

Inconclusion, the article addressed the critical issue of the racialdisparity in the prevalence of hypertension. In addition, the authorspresented some rare findings that there exist some unknown riskfactors that cause the disparity.


Hicken,T., Lee, H., Morenoff, J., House, J. &amp Williams, R. (2014).Racial/Ethnic Disparities in Hypertension Prevalence: Reconsideringthe Role of Chronic Stress. AmericanJournal of Public Health,104 (1), 117-123.



Thearticle “Stress and the Individual” was authored by Bruce McEwenand Eliot Stellar. The article was published by the Archives ofInternal Medicine in 1993. The authors discussed the connection thatexists between stress and processes that lead to the occurrence ofdifferent diseases or illnesses.

WhatI agree with

Itis well known that stress increases the risk of individuals to sufferfrom different diseases. The general knowledge that I and othermembers of the society have is that stress reduces the ability of thebody to fight infections and other medical conditions. I also agreewith the authors’ statement that different people have varyingabilities to fight stress and they are affected in different ways bystress. This can be observed on a daily basis where different peopleare affected differently by a similar event.

Usingthe information in health education career

Theinformation contained in the article established the relationshipbetween stress and factors (such as changes in the cardiovascularsystem and immune system) that leads to diseases (McEwen &ampStellar, 1993). In addition, the article informs about differentstressors in one’s environment. This is valuable information thatwill be used to educate members of the society about the stressorsthat they are likely to find in their environment and how to avoidthrees stressors. For an instant, it is now possible to explain to anindividual how social defeat, which is a common occurrence in life,can increase the risk of suffering from stress, suppresses the immunesystem, and cause chronic diseases.

Relationshipbetween the reading and a current health concern

Thearticle addresses stress, which is a significant issue of concern inthe U.S. This is because, it is estimated that about 72 % ofAmericans are suffering from stress and the cost of treating diseasesthat result from stress account for 8 % of the annual health carecost (American Psychological Association, 2015). Therefore, thecontent of the article is relevant and significant.

Inconclusion, stress is among the key factor that increases the risk ofsuffering from different medical conditions. The article “Stressand the Individual” give a vivid explanation of the connectionexisting between stress and different chronic medical conditions.


AmericanPsychological Association (2015). AmericanPsychological Association Survey Shows Money Stress Weighing onAmericans’ Health Nationwide.Washington, DC: APA.

McEwen,S. &amp Stellar, E. (1993). Stress and the individual. Archivesof Internal Medicine,153, 2093-2101.