Social
Racial and Ethnic Inequalities in Hypertension and Cardiovascular Diseases in the Latin American and Caribbean Region, 2000-2023: A Scoping Review Diana Higuera-Mendieta* Diana Higuera-Mendieta Higuera-Mendieta Higuera-Mendieta Higuera-Mendieta Higuera-Mendieta Higuera-Mendieta Higuera-Mendieta Higuera-Mendieta 1. Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA 2. Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
The Latin American and Caribbean region has a unique history of racialization rooted in the transatlantic slave trade, colonization, and the enduring legacy of racism, resulting in racial hierarchies that shape the unequal social, economic, and political reality of Afro-descendant and Indigenous people. This reality, in turn, shapes racial and ethnic inequalities in health, including hypertension and cardiovascular diseases (CVD). Yet, our understanding of these inequalities remains fragmented in the region due, in large part, to the lack of quality, reliable data, as well as competing conceptualizations of race and ethnicity and the underlying mechanisms that produce racial and ethnic inequalities in health. To better understand these challenges within the context of epidemiologic studies of hypertension and cardio vascular outcomes, we conducted a scoping review of the literature to: 1) describe how race and ethnicity are conceptualized and measured in studies of hypertension and CVD in Latin American and Caribbean countries; 2) describe observed patterns of racial and ethnic inequalities and the mechanisms used to explain them; and 3) identify the main data sources on race and ethnicity variables. We followed the Joanna Briggs Institute framework and PRISMA-ScR guidelines. We searched Seven databases for empirical studies reporting on racial or ethnic disparities in hypertension and CVD in 22 Latin American countries. Two reviewers independently screened, and four extracted data. A narrative synthesis was supported by tables and maps. We identified 43 studies published between January 1, 2000 and June 30, 2023, across seven countries in the region. While research on racial inequalities in these outcomes has increased over time, the conceptual and methodological rigor of epidemiologic studies should be improved to adequately document and address racial inequalities in hypertension and CVD and the underlying mechanisms rooted in racism that exacerbate them.