An internet survey investigating relationships among medication adherence, health status, and coping experiences with racism and/or oppression among hypertensive African Americans

African Americans suffer from disparate levels of cardiovascular disease including high blood pressure. Medication adherence has been documented to play a critical role. Thus, a measure of medication adherence was used, along with a set of new measures developed by the Research Group on Disparities in Health at Teachers College: Perception of Racism and/or Oppression Scale; When Racism and Oppression Happened To Me Scale; and the Coping and Responding to Racism and Oppression Scale---all of which showed good to adequate internal consistency (Cronbach's Alpha). Using these tools, relationships were explored with medication adherence and selected demographics with an Internet sample of 134 hypertensive African Americans. Results showed a low level of medication adherence and high ability to perceive racism and/or oppression. Over 95% were in the maintenance stage, suggesting experience practicing and refining adaptive coping responses to racism and/or oppression for greater than 6 months. Adaptive spiritual responses and adaptive behavioral responses were the coping skills most likely to be utilized by the participants in this study. Positive relationships were found between medication adherence and age, overall health status, quality of care, and skills needed to cope with racism and/or oppression. Negative relationships were found between medication adherence and annual household income, adaptive spiritual responses, adaptive cognitive responses, perception of racism, and adaptive behavioral responses. The significant predictors of medication adherence were: (1) not having a partner, (2) not employed, (3) better health status, (4) more skills to cope with racism, (5) less psychological disturbance, and (6) fewer adaptive behavioral behaviors.;Because racism and its impact on hypertension have contributed to the morbidity and mortality of African Americans, and that the type of skills utilized may mitigate the effects of racism and moderate health outcomes, it is imperative that the data from this and other studies be woven into intervention strategies to reduce the cardiovascular morbidity and mortality of African Americans and reduce health disparities. The new measures utilized in this study are recommended for future studies.