Journal of Urban Health

, Volume 93, Issue 2, pp 345–363

Local Actors’ Frames of the Role of Living Conditions in Shaping Hypertension Risk and Disparities in a Colombian Municipality

  • Diego I. Lucumi
  • Amy J. Schulz
  • Barbara A. Israel

DOI: 10.1007/s11524-016-0039-8

Cite this article as:
Lucumi, D.I., Schulz, A.J. & Israel, B.A. J Urban Health (2016) 93: 345. doi:10.1007/s11524-016-0039-8


Conditions in the social and physical environment influence population health and risk for CVD, including hypertension. These environmental conditions are influenced by the decisions of public officials, community leaders, and service providers. Examining the frames that local decision makers bring to understanding hypertension can provide important insights into the decisions that they make about strategies for addressing this problem in their jurisdiction. The goal of this study was to examine the frames that local decision makers in Quibdó, Colombia, bring to understanding hypertension risk, and in particular, whether and how they use frames that encompass associations between living conditions and hypertension risk. Data for this qualitative study were collected using a stratified sampling strategy. Semi-structured interviews were conducted in 2012 with 13 local decision makers and analyzed using a framework approach. Participants linked the structural conditions experienced in Quibdó, including displacement, limited economic opportunities, and the infrastructure of the city, to hypertension risk through multiple pathways, including behavioral risk factors for hypertension and physiologic responses to stress. They described the social patterning of these factors across socioeconomic, racial/ethnic, and gender hierarchies. Although several conditions associated with hypertension risk are widely distributed in the city’s population, social processes of marginalization and stratification create additional disadvantages for those on the lower rungs of the social hierarchy.


Hypertension Urban population Social inequity Social determinants of health Colombia 

Funding information

Funder NameGrant NumberFunding Note
Horace H. Rackham School of Graduate Studies, University of Michigan (US)

    Copyright information

    © The New York Academy of Medicine 2016

    Authors and Affiliations

    • Diego I. Lucumi
      • 1
    • Amy J. Schulz
      • 2
    • Barbara A. Israel
      • 2
    1. 1.School of MedicineUniversidad El BosqueBogotáColombia
    2. 2.Department of Health Behavior and Health EducationUniversity of Michigan, School of Public HealthAnn ArborUSA

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