This document discusses a study analyzing hypertension disparities using National Health Interview Survey data. The study aims to examine hypertension proportions by race, marital status, and work status. Descriptive statistics show hypertension rates are highest among Black Americans (14%) and widowed individuals (18%). Contingency analyses find significant associations between hypertension and race (p<0.001), marital status (p<0.001), and work status (p<0.001). Specifically, Black Americans and widowed individuals have higher observed hypertension counts than expected. The findings support the hypothesis that hypertension proportions differ by race.

1. Chi Square Presentation
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2. NCHS National Health Interview Survey
Goal: To collect data to measure and monitor the amount, distribution, effects, and risk of illness and
disability in the population and the utilization of health care services for such conditions and barriers to
utilization.
Intended use: For use by the Department of Health and Human Services (DHHS) and the public to monitor
trends in illness and disability and to track progress toward achieving many of the Healthy People objectives
for the nation, and for the public health research community to conduct epidemiologic and policy analysis of
such timely issues as characterizing those with various health problems, determining barriers to accessing
and using health care, and evaluating the impact of changes in federal health programs.

3. Significance of the project
1. The prevalence of hypertension continues to pose an enormous threat to the
public health in the United States, affecting roughly 30% of the United States
adults aged 18 years or older.
2. “The ‘job strain’ model proposed by Karasek states that the combination of high
job demands and low job decision latitude (high job strain or work stress) will lead
to negative physical health outcomes such as hypertension and cardiovascular
disease.”
3. According to a World Health Organisation publication, hypertension and other
cardiovascular diseases are amongst the main chronic diseases in the developed
and developing countries and consume an important proportion of their public
health budget.

4. Significance of the project
● Growing evidence from repeated studies have consistently reported a persistent disparity in
hypertension among racial/ethnic groups in United States adults,with non-Hispanic with African
Americans bearing the highest economic costs and disease burden and having the highest risk for
cardiovascular disease and stroke.
● Are African Americans genetically predisposed to hypertension? American Heart Association figures
show that over 40% of African American adults live with chronic hypertension (also known as high blood
pressure), compared to 30% of their white counterparts.
● “Recent evidence suggests that losing a spouse has differential impacts on men’s and women’s
cardiovascular health in older ages. It has been shown that marital disruption is associated with the
onset of cardiovascular disease in middle-aged women but not in men (Zhang & Hayward, 2006).”
● Considering the above facts we were interested to know more about disparities in hypertension by race,
marital status and work.

5. Research question
Research question 1
H0=Is the proportion of hypertension the same for all race?
H1= Is the proportion of hypertension not the same for the races?
Research question 2
H0=Is the proportion of hypertension the same for married spouse in household versus never married?
H1= Is the proportion of hypertension not the same for married spouse in household versus never married?
Research question 3
H0=Is the proportion of hypertension the same for those who work or ever worked?
H1= Is the proportion of hypertension not same for those who work or ever worked?

6. Univariate Variable description
OMB groups w/multiple race
01 White only
02 Black/African American only
03 AIAN only
04 Asian only
05 Race group not releasable*
06 Multiple race
Table 1 univariate descriptive statistics of race
Level Count Percentage
1 26524 80%
2 3685 11%
3 357 1%
4 1670 5%
5 105 0%
6 687 2%
Total 33028

7. Univariate Variable description
Marital Status
1 Married - spouse in household
2 Married - spouse not in household
3 Married - spouse in household unknown
4 Widowed
5 Divorced
6 Separated
7 Never married
8 Living with partner
9 Unknown marital status
Table 2 univariate descriptive statistics of marital status
Level Count Percentage
1 14160 43%
2 576 2%
4 3276 10%
5 4676 14%
6 856 3%
7 7463 23%
8 1953 6%
9 68 0%
Total 33028

8. Univariate Variable description
Sample adults 18+ years who were NOT working at
a job or business and not looking for work or
looking:
Ever worked
1 Yes
2 No
7 Refused
8 Not ascertained
9 Don't know
Table 3 univariate descriptive statistics of work
Level Count Percentage
yes 12725 90%
no 1476 10%
refused 12 0%
Don't know 1 0%
Total 14214

9. Univariate Variable description
Amount of people ever told they have hypertension:
1 Yes
2 No
7 Refused
8 Not ascertained
9 Don't know
Table 4 univariate descriptive statistics of
hypertension
Level Count Percentage
1 11664 35%
2 21315 65%
7 21 0%
9 28 0%
Total 33028

10. Bivariate Statistics description
Table 5 Bivariate statistics showing Who were told that they have
Hypertension by race
Level Count Percentage
White only 9182 79%
Black American only 1667 14%
AIAN only 116 1%
Asian only 457 4%
Race group not releasable 34 0%
Multiple race 208 2%
Total 11664
Table 6 Bivariate statistics showing Who were told that they
don't have hypertension by race
Level Count Percentage
White only 17302 81%
Black only 2015 9%
AIAN only 240 1%
Asian only 1210 6%
Race group not releasable 70 0%
Multiple race 478 2%
Total 21315

11. Bivariate Statistics
Table 7 Bivariate statistics showing Who were told that they have
Hypertension by ever work
Who were NOT working at a job or business and not looking for work or
looking
Level Count Percentage
Yes 6604 93%
No 491 7%
Not ascertained 3 0%
Don’t know 1 0%
Total 7099
Table 8 Bivariate statistics showing Who were told that they
don't have hypertension by ever work
Level Count Percentage
yes 6096 86%
no 981 14%
refused 7 0%
Total 7084

12. Bivariate Statistics
Table 9 Bivariate statistics showing Who were told that they have
Hypertension by Marital status
Level Count Percentage
Married - spouse in household 4966 43%
Married - spouse not in household 195 2%
Widowed 2051 18%
Divorced 2127 18%
Separated 359 3%
Never married 1484 13%
Living with partner 461 4%
Unknown marital status 21 0%
Total 11664
Table 10 Bivariate statistics showing Who were told that they
don't have hypertension by Marital status
Level Count Percentage
Married - spouse in household 9177 43%
Married - spouse not in household 379 2%
Widowed 1220 6%
Divorced 2540 12%
Separated 494 2%
Never married 5969 28%
Living with partner 1490 7%
Unknown marital status 46 0%
Total 21315

13. Contingency Analysis of Hypertension By Race
Fig 1 Mosaic plot HYPEv /Race Tests
N DF -LogLike RSquare (U)
33028 15 111.79 0.0051
ChiSquare Prob>ChiSq
Likelihood Ratio 223.59 <.0001
Pearson 232.86 <.0001
The pearson value is <0.05,There is a significant
difference between of hypertension by race

14. Fig2.Contingency Analysis of Hypertension By Race
Where are those differences ?
In this case,White,Black,Asian and multiple race
by hypertension has the chi square cell >1.96.
Black American, people have more hypertension
compared with other race.The actual count of
Black american are more than the expected count.

15. Contingency Analysis of Hypertension By Race
Result APA Format
The percentage of people with hypertension differ by race,(15,33028)=223.59,p<0.001
Is there an association? Yes
Value STd error Lower 95% Upper 9%
Kendall's Tau-b -0.0205 0.0054 -0.03 -0.010
Here the confidence interval do not include 0, its statistically significant.

16. Contingency Analysis of Hypertension by Marital Status
Fig 3 Mosaic Plot hypev/r-marital Tests
N DF -LogLike RSquare (U)
33028 21 1112.8959 0.0510
ChiSquare Prob>ChiSq
Likelihood Ratio 2225.792 <.0001
Pearson 2232.123 <.0001
The pearson value is <0.05,There is a significant
difference between of hypertension by marital
status.

17. Fig 4 Contingency Analysis of Hypertension by Marital Status
Where are those differences ?
In this case, widowed,divorced,separated,never married
and living with partner by hypertension has the chi
square cell >1.96 .
Widowed people have higher rate of hypertension
compared with other marital status. The actual count is
more expected count?

18. Contingency Analysis of Hypertension by Marital Status
Result APA
The percentage of people with hypertension differ by marital status(21,33028)=2225.7,p<0.001
Is there an association?
Yes.
Value Std err Lower 95% Upper 95%
Kendall's Tau-b 0.085 0.0048 0.076 0.095
Here the confidence interval do not include 0, its statistically significant.

19. Contingency Analysis of Hypertension by Everwork
Fig 5 Mosaic plot Hypertension/ everwork
Test
N DF -LogLike RSquare (U)
14214 9 102.10262 0.0101
Test ChiSquare Prob>ChiSq
Likelihood Ratio 204.205 <.0001
Pearson 343.874 <.0001

20. Fig 6 Contingency Analysis of Hypertension by Marital Ever work
Where are those differences ?
In this case, everwork yes and everwork no by
hypertension the cell chi square is>1.96.
The ever work yes had an expected amount that
was less than the the total amount.
The ever work no had an expected was more than
the total amount.

21. Contingency Analysis of Hypertension by Marital Ever work
.Result APA
The percentage of people with hypertension differ by Everwork(9,14214)=201.205,p<0.001.
Is there an association?
Yes
Value Stderr Lower 95% Upper 95%
Kendall's Tau-b 0.1144 0.0081 0.0986 0.1302
Here the confidence interval do not include 0, its statistically significant.

22. .Compare one of your research questions, ideally this would be a statistically significant
association, to results from the research you presented above. Are your findings supported?
Research question
The proportion of hypertension is not same for all race.
Yes,our finding support the fact that black race, do suffer from more
proportion of hypertension compared with white race.
The prevalence of Hypertension is more for black when compared with other race
Fig7. Contingency table
Hypertension/race

23. Reference
Schwandt, H. M., Coresh, J., & Hindin, M. J. (2010). Marital Status, Hypertension, Coronary Heart Disease, Diabetes, and Death
Among African American Women and Men: Incidence and Prevalence in the Atherosclerosis Risk in Communities (ARIC) Study
Participants. Journal of Family Issues, 31(9), 1211–1229. http://doi.org/10.1177/0192513X10365487
Mezuk, B., Kershaw, K. N., Hudson, D., Lim, K. A., & Ratliff, S. (2011). Job Strain, Workplace Discrimination, and Hypertension among
Older Workers: The Health and Retirement Study. Race and Social Problems, 3(1), 38–50. http://doi.org/10.1007/s12552-011-9041-7
Schwandt, H. M., Coresh, J., & Hindin, M. J. (2010). Marital Status, Hypertension, Coronary Heart Disease, Diabetes, and Death
Among African American Women and Men: Incidence and Prevalence in the Atherosclerosis Risk in Communities (ARIC) Study
Participants. Journal of Family Issues, 31(9), 1211–1229. http://doi.org/10.1177/0192513X10365487