Abstract:
Background: Elevated blood pressure is the leading risk factor for global mortality. While it is known that there exist
differences between men and women with respect to socioeconomic status, self-reported health, and healthcare
utilization, there are few published studies from Africa. This study therefore aims to characterize differences in self-
reported health status, healthcare utilization, and costs between men and women with elevated blood pressure in
Kenya.
Methods: Data from 1447 participants enrolled in the LARK Hypertension study in western Kenya were analyzed.
Latent class analysis based on five dependent variables was performed to describe patterns of healthcare utilization
and costs in the study population. Regression analysis was then performed to describe the relationship between
different demographics and each outcome.
Results: Women in our study had higher rates of unemployment (28% vs 12%), were more likely to report lower
monthly earnings (72% vs 51%), and had more outpatient visits (39% vs 28%) and pharmacy prescriptions (42% vs
30%). Women were also more likely to report lower quality-of-life and functional health status, including pain,
mobility, self-care, and ability to perform usual activities. Three patterns of healthcare utilization were described:
(1) individuals with low healthcare utilization, (2) individuals who utilized care and paid high out-of-pocket costs,
and (3) individuals who utilized care but had lower out-of-pocket costs. Women and those with health insurance
were more likely to be in the high-cost utilizer group.
Conclusions: Men and women with elevated blood pressure in Kenya have different health care utilization
behaviors, cost and economic burdens, and self-perceived health status. Awareness of these sex differences can
help inform targeted interventions in these populations.