Educational Differences in Hypertension Diagnosis After Elevated Blood Pressure

• In Event: Medical Sociology Section Roundtables
  In Refereed Roundtable (90 minute): Table 23. Social Determinants of Population Health

Abstract

Education shapes health at multiple points along the disease trajectory. This study tests whether and how education matters at the transition from an abnormal clinical indicator to formal diagnosis. Using a nationally representative sample of U.S. older adults from the Health and Retirement Study, I examine how blood pressure examination results influence subsequent hypertension diagnosis. I exploit clinical cutoffs (SBP 140/DBP 90 for hypertension; SBP 120/DBP 80 as an elevated benchmark) in a regression discontinuity design to estimate the causal effect of an abnormal reading on diagnosis. At the threshold, diagnosis probabilities differ markedly by education, with larger conversion among college‑educated adults. Yet, comparing HRS to a cross‑sectional benchmark shows that this advantage does not translate into higher overall diagnosis rates, even in the presence of panel‑conditioning effects; instead, lower‑educated adults exhibit larger increases in diagnosis, consistent with worse baseline health and more limited access to care. These findings indicate that interventions targeting follow‑through among lower‑SES older adults can still reduce inequality.

Author

• Won-tak Joo, University of Florida