Hypertension in St. Lucia: social and cultural dimensions

ABSTRACT

This study examines the social and cultural correlates of essential hypertension, or high blood pressure, in St. Lucia, in the West Indies. The research is organized around the investigation of the following 3 topics (1) the social and cultural risk factors that contribute to the development of hypertension; (2) the social and cultural factors that serve a beneficial or protective function with respect to the development of hypertension; and (3) the cultural factors affecting patient adherance to the treatment of essential hypertension. Fieldwork was conducted in a St. Lucian town for 11 monts during 1976 and 1977. A mix of qualitative and quantitative methods were used. During the first half of the fieldwork participant observation and key-informant interviewing were used as the primary data-gathering techniques to establish the major social, cultural, and psychological variables relevant to the research. During the second half of the fieldwork quantitative data were gathered using survey methods. Data gathered on a probability sample of a hundred 40- to 49 year olds were used to test etiologic hypotheses. Data were also gathered on a sample of 40 hypertensives under treatment at a local clinic to test hypotheses about patient adherance. Multivariate statistical methods were used to evaluate the hypotheses. The following major conclusions wer reached (1) St. Lucia has undergone a process of "de-localization", or increasing dependence on non-local sources of energy and information, over the past two decades which has increased socioeconomic differentiation on the island. (2) Those individuals who aspire to a life style characterized by the acquisition of material items, but who lack the economic resources for the maintenance of that life style, have a risk of hypertension. (3) Those individuals who are embedded in a larger social network providing effective and instrumental social support have a lower risk of hypertension. (4) There is a non-addictive relationship between risk factors, social supports, and arterial pressure; that is, the deleterious effects of risk factors are contingent upon the level of social supports available to the individual (AU)