Addressing hypertension among Haitian adults with insufficient access to quality healthcare: A discursive review.

AIM: The purpose of this article is to summarize research targeting hypertension and healthcare access among adults living in rural Haiti. BACKGROUND: Hypertension is a significant public health problem that impacts one in five persons globally. It is the leading cause of cardiovascular-related conditions such as stroke and myocardial infarction and accounts for most global non-communicable disease-related deaths. Limited healthcare access and social determinants of health are known contributors to poor health outcomes among persons with hypertension. Among Haitians, there are stark health disparities between those who live in urban versus rural areas. DESIGN: A discursive review. RESULTS: Several issues are identified as barriers to proper hypertension prevention and management. However, after examining the effective interventions, we found that social determinants of health such as transportation costs, lack of field care facilities close to patients, roadway conditions, political disturbance, and ineffective leadership and policies are major barriers to controlling hypertension in Haiti. Although Haiti has received help from international organizations, strengthening its internal infrastructure is paramount in improving healthcare access. DISCUSSION: The review concludes that Haitians living in rural parts of Haiti are less likely to receive healthcare to manage non-communicable diseases such as hypertension. Similar to other developing countries, a heightened awareness is needed to address the lack of healthcare access for those living in rural communities. IMPACT TO NURSING PRACTICE: Nurses and other healthcare professionals working with populations in Haiti should become aware of the barriers and facilitators that promote sufficient healthcare access. To achieve this goal, nurses must understand the social determinants and other factors that serve as barriers for achieving access to quality care for this vulnerable population. NO PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public involvement in the design or drafting of this discursive paper.

The Educational, Health, and Economic Impacts of COVID-19 Among Haitians in the USA: Time for Systemic Change.

Haitians are the fourth largest Afro-Caribbean immigrant group in the USA, and there is a dearth of research focusing on the factors impacting their lives. As a marginalized group with extensive pre-existing conditions, Haitian immigrants are disproportionately affected by the pandemic in areas such as education, health, and economics. This paper provides a summary of existing disparities among Haitians in the USA and how COVID-19 has significantly impacted this group. It concludes with an analysis of how the Strategic Framework for Improving Racial and Ethnic Minority Health and Eliminating Racial and Ethnic Health Disparities can be used to guide, organize, and coordinate systematic planning for sustainable changes to address these disparities. Addressing immigrant and minority health in the USA requires a deeper dive into the various immigrant groups. This paper concludes with recommendations for research and policy changes necessary to eliminate disparities in the USA.

Diabetes Mellitus Prevalence Among Haitian American Afro-Caribbeans in the United States.

To measure the prevalence of diabetes mellitus among Haitian American Afro-Caribbeans, a quantitative descriptive cross-sectional study was conducted using a convenience sample of 151 Haitian Americans in New York, New Jersey, and Florida. The results of the study revealed an age-adjusted prevalence of diabetes mellitus of 39.9% (95% CI 29.8% - 50.1%). This is greater than the prevalence in the U.S. population (12%) (Z = 5.54, p < 0.05) and the prevalence in the Black, non-Hispanic population (16.8%) (Z = 3.35, p < 0.05). There were 79 (52.3%) individuals with diabetes mellitus, of which 21 (13.9%) were individuals who were previously undiagnosed; and 56 (37%) were individuals who were taking medication(s) for controlling glucose. At a 39.9% prevalence rate of diabetes, Haitian Americans have an age-adjusted prevalence rate of diabetes that is more than twice the prevalence rate of diabetes in Black, non-Hispanic Americans and more than 3 times the rate in White, non-Hispanics. This rate is comparable to the prevalence rate in Native Americans of the Pima tribe. An urgent need exists to confirm these findings in a larger cohort.

Integrative Review on Adherence in Haitians With Diabetes.

In light of a marked increase in the incidence and prevalence of diabetes in the United States in recent years with associated health costs totaling $245 billion for 2012, diabetes has become a major health and fiscal concern. Haitian Americans as a cultural group have unique obstacles to effective treatment and management of diabetes. This paper analyzes recent studies relevant to these challenges in anticipation of new research pertaining to this population. Although medication compliance is generally referred to as adherence, it is a complex concept and key challenge in diabetes care. Accordingly, this paper will further define adherence by describing its relevance in effective treatment and management. It will also analyze key theoretical perspectives in diabetes care, summarize recent research, and make recommendations for effective future research on the impact of diabetes education in Haitian Americans.