The study by Ursua et al.1 investigates the awareness, treatment and control of hypertension among New York City (NYC) Filipino immigrants (FI). The results highlighted that most of the immigrants who were found to be hypertensive at their screen (72.1 %) were aware of their diagnosis, and over half (56.5 %) were on treatment, but less than a quarter had well-controlled blood pressure. This is lower than other NYC residents (NYC Health And Nutrition Examination Survey). In particular, control was much lower (47.1 % vs. 21.7 %).2

There are a myriad of studies that show disparities in health and health outcomes for minority and disadvantaged populations. The next step after identification is to tease out unique characteristics for specific populations, to root out the causes of disparities and try to intervene. This study found that awareness and treatment rates among young and middle-aged FI are very low, and that the elderly FI, a population with very high prevalence of hypertension,3 and those living in United States for >15 years are more likely to be on treatment. While insurance status was not associated with likelihood of being on treatment, it nearly doubled the odds of blood pressure being well controlled. This study did not look at the impact of access to regular medical care on hypertension control. Future studies need to examine the importance of various factors, both genetic and cultural, that might influence health behaviors and outcomes. Developing effective interventions to improve health stems from understanding the influence of various factors on health. What are the FI cultural beliefs about diet, exercise or weight control? Do new immigrants prefer nontraditional health providers? Who influences the FI culture in NYC? Are there problems with access to health care? Do FI have access to healthy food? Is there a gap in the understanding of the importance of hypertension on long-term outcomes? It is time to move beyond demonstrating that disparities exist and to explore the underlying causes. Tailoring effective interventions rests upon understanding these influences.