Journal of Behavioral Medicine

, Volume 40, Issue 2, pp 271–280 | Cite as

Fatalism and hypertension prevalence, awareness, treatment and control in US Hispanics/Latinos: results from HCHS/SOL Sociocultural Ancillary Study

  • Angela P. Gutierrez
  • Jessica L. McCurley
  • Scott C. Roesch
  • Patricia Gonzalez
  • Sheila F. Castañeda
  • Frank J. Penedo
  • Linda C. Gallo


Compared with non-Hispanic whites, US Hispanics/Latinos display similar hypertension prevalence, but lower awareness, treatment, and control. Sociocultural factors may affect these patterns. Fatalism, the belief that health is predetermined by fate, relates to poorer adoption of risk reducing health behaviors. We examined the association of fatalism with hypertension prevalence, awareness, treatment, and control among 5313 Hispanics/Latinos, ages 18–74, who were enrolled from four US communities in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study. After accounting for socioeconomic status and acculturation in logistic regression analyses, higher fatalism was associated with increased odds of hypertension (OR 1.14, 95 % CI 1.02, 1.28). This association was non-significant when diabetes and other health-related covariates were statistically adjusted. Fatalism was not associated with hypertension awareness, treatment, or control. Findings suggest that the association of fatalism with hypertension may be due largely to its association with SES, acculturation, or related health conditions.


Fatalism Hispanic Hypertension Latino Sociocultural 



The Hispanic Community Health Study/Study of Latinos was carried out as a collaborative study supported by contracts from the National Heart, Lung, and Blood Institute (NHLBI) to the University of North Carolina (N01-HC65233), University of Miami (N01-HC65234), Albert Einstein College of Medicine (N01-HC65235), Northwestern University (N01-HC65236), and San Diego State University (N01-HC65237). The following Institutes/Centers/Offices contribute to the HCHS/SOL through a transfer of funds to the NHLBI: National Institute on Minority Health and Health Disparities, National Institute on Deafness and Other Communication Disorders, National Institute of Dental and Craniofacial Research, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Neurological Disorders and Stroke, NIH Institution-Office of Dietary Supplements. The HCHS/SOL Sociocultural Ancillary Study was supported by grant 1 RC2 HL101649 from the NIH/NHLBI (Gallo/Penedo PIs). The authors thank the staff and participants of HCHS/SOL and of the HCHS/SOL Sociocultural Ancillary Study for their important contributions.

Compliance with ethical standards

Conflict of interest

Angela P. Gutierrez, Jessica L. McCurley, Scott C. Roesch, Patricia Gonzalez, Sheila F. Castañeda, Frank J. Penedo, and Linda C. Gallo declare that they do not have any conflict of interest.

Human and animal rights and Informed consent

All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.


  1. Abraido-Lanza, A. F., Martins, M. C., Shelton, R. C., & Florez, K. R. (2015). Breast cancer screening among Dominican Latinas: A closer look at fatalism and other social and cultural factors. Health Education and Behavior, 42, 633–641. doi: 10.1177/1090198115580975 CrossRefPubMedGoogle Scholar
  2. Abraido-Lanza, A. F., Viladrich, A., Florez, K. R., Cespedes, A., Aguirre, A. N., & De La Cruz, A. A. (2007). Fatalismo reconsidered: A cautionary note for health-related research and practice with Latino populations [Commentary]. Ethnicity and Disease, 17(1), 153–158. Retrieved from
  3. Alegria, M. (2009). The challenge of acculturation measures: What are we missing? A commentary on Thomson & Hoffman-Goetz. Social Science and Medicine, 69, 996–998. doi: 10.1016/j.socscimed.2009.07.006 CrossRefPubMedPubMedCentralGoogle Scholar
  4. American Diabetes Association. (2010). Diagnosis and classification of diabetes mellitus. Diabetes Care, 33, S62–S69. doi: 10.2337/dc10-S062 CrossRefPubMedCentralGoogle Scholar
  5. Aranda, J. M, Jr., & Vazquez, R. (2004). Awareness of hypertension and diabetes in the Hispanic community. Clinical Cornerstone, 6, 7–13. doi: 10.1016/S1098-3597(04)80060-7 CrossRefPubMedGoogle Scholar
  6. Armstrong, T., & Bull, F. (2006). Development of the world health organization global physical activity questionnaire (GPAQ). Journal of Public Health, 14, 66–70. doi: 10.1007/s10389-006-0024-x CrossRefGoogle Scholar
  7. Austin, L. T., Ahmad, F., McNally, M. J., & Stewart, D. E. (2002). Breast and cervical cancer screening in Hispanic women: A literature review using the health belief model. Women’s Health Issues, 12, 122–128. doi: 10.1016/S1049-3867(02)00132-9 CrossRefPubMedGoogle Scholar
  8. Betancourt, J. R., Carrillo, J. E., Green, A. R., & Maina, A. (2004). Barriers to health promotion and disease prevention in the Latino population. Clinical Cornerstone, 6, 16–29. doi: 10.1016/S1098-3597(04)80061-9 CrossRefPubMedGoogle Scholar
  9. Caban, A., & Walker, E. A. (2006). A systematic review of research on culturally relevant issues for Hispanics with diabetes. The Diabetes Educator, 32, 584–595. doi: 10.1177/0145721706290435 CrossRefPubMedGoogle Scholar
  10. Castaneda, S. F., Malcarne, V. L., Foster-Fishman, P. G., Davidson, W. S., Mumman, M. K., Riley, N., et al. (2014). Health care access and breast cancer screening among Latinas along the California–Mexican border. Journal of Immigrant and Minority Health, 16, 670–681. doi: 10.1007/s10903-013-9938-x CrossRefPubMedPubMedCentralGoogle Scholar
  11. Cheung, B. M., & Li, C. (2012). Diabetes and hypertension: Is there a common metabolic pathway? Current Atherosclerosis Report, 14, 160–166. doi: 10.1007/s11883-012-0227-2 CrossRefGoogle Scholar
  12. Chiuve, S. E., Fung, T. T., Rimm, E. B., Hu, F. B., McCullough, M. L., Wang, M., et al. (2012). Alternative dietary indices both strongly predict risk of chronic disease. The Journal of Nutrition, 142, 1009–1018. doi: 10.3945/jn.111.157222 CrossRefPubMedPubMedCentralGoogle Scholar
  13. Chobanian, A. V., Bakris, G. L., Black, H. R., Cushman, W. C., Green, L. A., Izzo, J. L, Jr., et al. (2003). The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: The JNC 7 report. JAMA, 289, 2560–2571. doi: 10.1001/jama.289.19.2560 CrossRefPubMedGoogle Scholar
  14. Christian, A. H., Rosamond, W., White, A. R., & Mosca, L. (2007). Nine-year trends and racial and ethnic disparities in women’s awareness of heart disease and stroke: An American Heart Association national study. Journal of Women’s Health, 16, 68–81. doi: 10.1089/jwh.2006.M072 CrossRefPubMedGoogle Scholar
  15. Cuellar, I., Arnold, B., & Gonzalez, G. (1995). Cognitive referents of acculturation: Assessment of cultural constructs in Mexican Americans. Journal of Community Psychology, 23, 339–356. doi: 10.1002/1520-6629(199510)23:4<339:AID-JCOP2290230406>3.0.CO;2-7 CrossRefGoogle Scholar
  16. De Jesus, M., & Xiao, C. (2014). Predicting health care utilization among Latinos: Health locus of control beliefs or access factors? Health Education and Behavior, 41, 423–430. doi: 10.1177/1090198114529130 CrossRefPubMedGoogle Scholar
  17. de Los Espinosa Monteros, K., & Gallo, L. C. (2011). The relevance of fatalism in the study of Latinas’ cancer screening behavior: A systematic review of the literature. International Journal of Behavioral Medicine, 18, 310–318. doi: 10.1007/s12529-010-9119-4 CrossRefGoogle Scholar
  18. de Los Espinosa Monteros, K., & Gallo, L. C. (2013). Fatalism and cardio-metabolic dysfunction in Mexican–American women. International Journal of Behavioral Medicine, 20, 487–494. doi: 10.1007/s12529-012-9256-z CrossRefGoogle Scholar
  19. Drew, E. M., & Schoenberg, N. E. (2011). Deconstructing fatalism: Ethnographic perspectives on women’s decision making about cancer prevention and treatment. Medical Anthropology Quarterly, 25, 164–182. doi: 10.1111/j.1548-1387.2010.01136.x CrossRefPubMedPubMedCentralGoogle Scholar
  20. Epstein, M., & Sowers, J. R. (1992). Diabetes mellitus and hypertension. Hypertension, 19, 403–418. doi: 10.1161/01.HYP.19.5.403 CrossRefPubMedGoogle Scholar
  21. Gallo, L. C., Penedo, F. J., Carnethon, M., Isasi, C. R., Sotres-Alvarez, D., & Malcarne, V. L., et al. (2014). The Hispanic community health study/study of Latinos Sociocultural Ancillary Study: Sample, design, and procedures. Ethnicity and Disease, 24(1), 77–83. Retrieved from
  22. Go, A. S., Mozaffarian, D., Roger, V. L., Benjamin, E. J., Berry, J. D., Borden, W. B., et al. (2013). Heart disease and stroke statistics 2013 update: A report from the American Heart Association. Circulation, 127, e6–e245. doi: 10.1161/CIR.0b013e31828124ad CrossRefPubMedGoogle Scholar
  23. Gu, Q., Burt, V. L., Dillon, C. F., & Yoon, S. (2012). Trends in antihypertensive medication use and blood pressure control among United States adults with hypertension: The National Health and Nutrition Examination Survey, 2001 to 2010. Circulation, 126, 2105–2114. doi: 10.1161/CIRCULATIONAHA.112.096156 CrossRefPubMedGoogle Scholar
  24. Hong, T. B., Oddone, E. Z., Dudley, T. K., & Bosworth, H. B. (2006). Medication barriers and anti-hypertensive medication adherence: The moderating role of locus of control. Psychology, Health, and Medicine, 11, 20–28. doi: 10.1080/14786430500228580 CrossRefPubMedGoogle Scholar
  25. IBM Corp. (2013). SPSS statistics for windows (Version 22.0) [Computer software]. Armonk, NY: IBM Corp.Google Scholar
  26. Kaplan, N. M., & Victor, R. G. (2010). Kaplan’s clinical hypertension. Philadelphia, PA: Wollters Kluwer Health/Lippincott Williams & Wilkins.Google Scholar
  27. Khatib, R., Schwalm, J. D., Yusuf, S., Haynes, R. B., McKee, M., Khan, M., et al. (2014). Patient and healthcare provider barriers to hypertension awareness, treatment and follow up: A systematic review and meta-analysis of qualitative and quantitative studies. PLoS One, 9, e84238. doi: 10.1371/journal.pone.0084238 CrossRefPubMedPubMedCentralGoogle Scholar
  28. Lavange, L. M., Kalsbeek, W. D., Sorlie, P. D., Aviles-Santa, L. M., Kaplan, R. C., Barnhart, J., et al. (2010). Sample design and cohort selection in the Hispanic community health study/study of Latinos. Annals of Epidemiology, 20, 642–649. doi: 10.1016/j.annepidem.2010.05.006 CrossRefPubMedPubMedCentralGoogle Scholar
  29. Mosca, L., Mochari, H., Christian, A., Berra, K., Taubert, K., Mills, T., et al. (2006). National study of women’s awareness, preventive action, and barriers to cardiovascular health. Circulation, 113, 525–534. doi: 10.1161/CIRCULATIONAHA.105.588103 CrossRefPubMedGoogle Scholar
  30. Muthén, L. K., & Muthén, B. O. (1998–2012). Mplus user’s guide. (7th ed.,). Los Angeles, CA: Muthén & Muthén.Google Scholar
  31. Niederdeppe, J., & Levy, A. G. (2007). Fatalistic beliefs about cancer prevention and three prevention behaviors. Cancer Epidemiology, Biomarkers and Prevention, 16, 998–1003. doi: 10.1158/1055-9965.EPI-06-0608 CrossRefPubMedGoogle Scholar
  32. Nwankwo, T., Yoon, S. S., Burt, V., & Gu, Q. (2013). Hypertension among adults in the United States: National health and nutrition examination survey, 20112012. (NCHS data brief No. 133). Retrieved from
  33. Perez-Stable, E., Eliseo, J., & Salazar, R. (2004). Issues in achieving compliance with antihypertensive treatment in the Latino population. Clinical Cornerstone, 6, 49–64. doi: 10.1016/S1098-3597(04)80064-4 CrossRefPubMedGoogle Scholar
  34. Pickering, T. G., Hall, J. E., Appel, L. J., Falkner, B. E., Graves, J., Hill, M. N., et al. (2005). Recommendations for blood pressure measurement in humans and experimental animals part 1: Blood pressure measurement in humans: A statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Hypertension, 45, 142–161. doi: 10.1161/01.HYP.0000150859.47929.8e CrossRefPubMedGoogle Scholar
  35. Sorlie, P. D., Allison, M. A., Aviles-Santa, L. M., Cai, J., Daviglus, M. L., Howard, A. G., et al. (2014). Prevalence of hypertension, awareness, treatment, and control in the Hispanic community health study/study of Latinos. American Journal of Hypertension, 27, 793–800. doi: 10.1093/ajh/hpu003 CrossRefPubMedPubMedCentralGoogle Scholar
  36. Sorlie, P. D., Aviles-Santa, L. M., Wassertheil-Smoller, S., Kaplan, R. C., Daviglus, M. L., Giachello, A. L., et al. (2010). Design and implementation of the Hispanic community health study/study of Latinos. Annals of Epidemiology, 20, 629–641. doi: 10.1016/j.annepidem.2010.03.015 CrossRefPubMedPubMedCentralGoogle Scholar
  37. Stanton, A. L. (1987). Determinants of adherence to medical regimens by hypertensive patients. Journal of Behavioral Medicine, 10, 377–394. doi: 10.1007/bf00846477 CrossRefPubMedGoogle Scholar
  38. Straughan, P., & Seow, A. (1998). Fatalism reconceptualized: A concept to predict health screening behavior. Journal of Gender, Culture, and Health, 3, 85–100. doi: 10.1023/A:1023278230797 CrossRefGoogle Scholar
  39. Thomson, M. D., & Hoffman-Goetz, L. (2009). Defining and measuring acculturation: A systematic review of public health studies with Hispanic populations in the United States. Social Science and Medicine, 69, 983–991. doi: 10.1016/j.socscimed.2009.05.011 CrossRefPubMedGoogle Scholar
  40. Xu, J., Murphy, S. L., Kochanek, K. D., & Bastian, B.A. (2016). Deaths: Final data for 2013 (CDC National Vital Statistics Report Vol. 64 No. 2). Retrieved from
  41. Yoon, S. S., Ostchega, Y., & Louis, T. (2010). Recent trends in the prevalence of high blood pressure and its treatment and control, 19992008. (NCHS data brief No. 48). Retrieved from
  42. Younger, J., Finan, P., Zautra, A., Davis, M., & Reich, J. (2008). Personal mastery predicts pain, stress, fatigue, and blood pressure in adults with rheumatoid arthritis. Psychology and Health, 23, 515–535. doi: 10.1080/08870440701596593 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Angela P. Gutierrez
    • 1
  • Jessica L. McCurley
    • 1
  • Scott C. Roesch
    • 2
  • Patricia Gonzalez
    • 3
  • Sheila F. Castañeda
    • 3
  • Frank J. Penedo
    • 4
  • Linda C. Gallo
    • 2
  1. 1.Joint Doctoral Program in Clinical PsychologySan Diego State University/University of California San DiegoSan DiegoUSA
  2. 2.Department of PsychologySan Diego State UniversitySan DiegoUSA
  3. 3.Graduate School of Public HealthSan Diego State UniversitySan DiegoUSA
  4. 4.Department of Medical Social Sciences, Feinberg School of MedicineNorthwestern UniversityChicagoUSA

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