Assignment Prompt & Instructions
– ## Forthisassignmentyouwillsubmit.docx
– ## HealthpromotionWeek2..pdf
**## Forthisassignmentyouwillsubmit.docx**
For this assignment you will submit Part One of your proposal, detailing a health problem that is
prevalent within your selected group and demonstrating your research of health promotion strategies for
addressing this specific health problem. At this point, you already developed in your discussions the core ideas of the topic contained in this assignment. You will use the same information, but it won’t be a copy-and-paste exercise. The purpose is that you enhance your ideas with the comments and outcomes of the weekly discussions and previous evaluations.
Directions
1. Introduction. Describe the health problem. Don't type "Introduction". (1 paragraph at least).
Using data and statistics, support your claim that the issue you selected is a problem.
What specifically will you address in your proposed health promotion program?
Be sure your proposed outcome is realistic and measurable.
2. Describe the vulnerable population. (1-3 paragraphs).
What are the risk factors that make this a vulnerable population?
Use evidence to support the risk factors you have identified.
3. Provide a review of literature from scholarly journals (at least 2) of evidence-based interventions that address the problem. (2 paragraphs, one for each article).
After completing a literature search related to effective interventions for your chosen health promotion activity, write a review that evaluates the strengths and weaknesses of all the sources you have found. (2-3 paragraphs).
4. Select and present an appropriate health promotion/disease prevention theoretical or conceptual model that best serves as the guiding framework for the proposal. (2-3 paragraphs).
For this assignment, a conclusion paragraph is not required.
Writing Assignment Requirements
Three to five pages in length (excluding title page, references, and appendices)
Follow APA format
Cite a minimum of 6 references
Please review the rubric prior to submission.
**## HealthpromotionWeek2..pdf**
1
Health Problem Proposal: Hypertension and Health Disparities
Anisleidy Alvarez
Florida national University
Health Promotion & Role Development in Adv. Nursing Practice
Dr. Nora Hernandez-Pupo
November 8, 2025
2
Health Problem Proposal: Hypertension and Health Disparities
Hypertension is a widespread and extremely important public health problem given its
wide-ranging impact on cardiovascular morbidity and mortality. Hypertension can be
asymptomatic for many individuals, yet it plays a significant role in heart disease, stroke, kidney
failure, and other critical health conditions. Given its high prevalence and the fact that control is
still suboptimal, hypertension is a major burden to health systems and individual quality of life
(Goorani et al. 2024). Importantly, differences are present in the occurrence, recognition,
management, and regulation across racial/ethnic, socioeconomic, and geographic boundaries,
emphasizing the necessity for health promotion and prevention initiatives to address both clinical
health aspects and social determinants of health. The substantial health impact of hypertension
provides a rationale for the choice of this condition for implementation in a health promotion
program that addresses the issues of disparities at multiple levels.
Global Relevance
Globally, hypertension is becoming a major global burden of disease-causing millions of
deaths per year associated with cardiovascular disease. Although the occurrence of uncontrolled
BP differs globally and regionally, in low and middle-income countries, a growing burden of
uncontrolled BP is associated with low access to care and resources (Schutte et al., 2021).
Almost half of hypertensive adults worldwide are unaware of their condition, elevating their risk.
(CDC, 2025). This is a global issue, which contributes to the underdevelopment of multinational
and cross-culture strategies for blood pressure awareness and control. International screening,
education and standardized treatment protocols are important because hypertension is usually
"silent." The international nature of hypertension makes it clear that while the previous efforts to
3
address it through local interventions are very important, the international nature of the problem
requires coordination across health systems.
National Level
At the national level in the US, however, the prevalence of hypertension has remained
alarmingly high. According to data available for August 2021-August 2023, nearly 1 in 2 US
adults had hypertension (defined as >=130/80 mm Hg or on antihypertensive medication) at 47.7
percent (Fryar et al., 2024). The rates of awareness, treatment, and control remain below optimal
levels. For instance, only one-fifth of adults with hypertension achieved blood pressure control
below 130/80 mm Hg during the specified period. Racial and ethnic disparities persist: non-
Hispanic Black individuals experience higher rates of hypertension compared to non-Hispanic
White or Hispanic individuals (48.8 percent versus 37.6 percent and 27.9 percent, respectively)
and face challenges with controlling blood pressure (Sells et al., 2023). These disparities are
linked to socioeconomic status and educational accomplishment, and access to care. For
example, poverty and lower education are associated with cardiovascular disease, particularly in
Black and Hispanic adults. Given the prevalence, poor control, and inequities in control and
treatment, a national health promotion strategy targeting understanding, screening, access, and
control is clearly needed.
Local Level
At a more localized level, within the state of Florida, hypertension continues to pose a
significant concern with spatial and social segregation. A recent data set shows that 35.9 percent
of Florida adults reported having been told by a health professional that they had high BP.
(America’s Health Ranking, 2023). Among federally qualified health centers (FQHCs) in Florida
4
in 2017, the statewide average hypertension control rate was about 57 % with much lower
hypertension control rates (37.8 %-51.4 %) in the lowest tertile, occurring mostly in northern
Florida counties which also have higher rates of BP-related death (CDC, 2024). These data
characterize the communities of disparity within a single state: factors of geography,
socioeconomic, and access are at play in creating disparities. For a health-promotion endeavor in
Florida, targeting areas with low control rates as well as underserved populations and/or linkage
to primary care and community outreach would be directly relevant and warranted.
Conclusion
Given the widespread prevalence of hypertension around the world, as well as the high
prevalence of the condition in the United States as a whole, as well as the differences in
prevalence, control, and outcomes that are specific to the state of Florida, the argument in favor
of developing multilevel health promotion programs is persuasive. For programs to be
successful, they must be implemented on a global, national, and local scale. Several of the
promotion strategies have the potential to lessen the burden of hypertension and to reduce health
disparities. These strategies include addressing the social determinants of health, developing
greater access to screening and care, improving awareness and compliance, and tailoring the
intervention to the needs of populations that are underserved. Therefore, hypertension is a health
problem selection that is suitable for the construction of a health promotion program that will
span the global, national, and local levels, as well as the inequities that exist in the prevention
and control of the problem. Both of these levels will be addressed in the program.
5
References
America’s Health Ranking. (2023). Explore High Blood Pressure in Florida | AHR.
Americashealthrankings.org.
https://www.americashealthrankings.org/explore/measures/Hypertension/FL
CDC. (2024, August 28). Hypertension Control among Federally Qualified Health Centers
(FQHCs) and Hypertension Death Rates by County, Florida. Heart Disease and Stroke
Maps. https://www.cdc.gov/heart-disease-and-stroke-data/data-vis/fl-hypertension-
fqhc.html
CDC. (2025, January 28). High blood pressure facts. High Blood Pressure.
https://www.cdc.gov/high-blood-pressure/data-research/facts-stats/index.html
Fryar, C., Kit, B., Carroll, M., Afful, J., Warren, A., Zablotsky, B., Leadbetter, E., & Maitland,
A. (2024). Hypertension Prevalence, Awareness, Treatment, and Control among Adults
Ages 18 and Older:United States, August 2021—August 2023. NCHS Data Brief, 511.
https://doi.org/10.15620/cdc/164016
Goorani, S., Zangene, S., & Imig, J. D. (2024). Hypertension: A Continuing Public Healthcare
Issue. International Journal of Molecular Sciences, 26(1), 123–123.
https://doi.org/10.3390/ijms26010123
Schutte, A. E., Venkateshmurthy, N. S., Mohan, S., & Prabhakaran, D. (2021). Hypertension in
Low- and Middle-Income Countries. Circulation Research, 128(7), 808–826.
https://doi.org/10.1161/circresaha.120.318729
Sells, M., Blum, E., Perry, G. S., Eke, P. I., & Presley-Cantrell, L. (2023). Excess Burden of
Poverty and Hypertension, by Race and Ethnicity, on the Prevalence of Cardiovascular
Disease. Preventing Chronic Disease, 20(20). https://doi.org/10.5888/pcd20.230065
**## HealthpromotionWeek2..pdf**
1
Health Problem Proposal: Hypertension and Health Disparities
Anisleidy Alvarez
Florida national University
Health Promotion & Role Development in Adv. Nursing Practice
Dr. Nora Hernandez-Pupo
November 8, 2025
2
Health Problem Proposal: Hypertension and Health Disparities
Hypertension is a widespread and extremely important public health problem given its
wide-ranging impact on cardiovascular morbidity and mortality. Hypertension can be
asymptomatic for many individuals, yet it plays a significant role in heart disease, stroke, kidney
failure, and other critical health conditions. Given its high prevalence and the fact that control is
still suboptimal, hypertension is a major burden to health systems and individual quality of life
(Goorani et al. 2024). Importantly, differences are present in the occurrence, recognition,
management, and regulation across racial/ethnic, socioeconomic, and geographic boundaries,
emphasizing the necessity for health promotion and prevention initiatives to address both clinical
health aspects and social determinants of health. The substantial health impact of hypertension
provides a rationale for the choice of this condition for implementation in a health promotion
program that addresses the issues of disparities at multiple levels.
Global Relevance
Globally, hypertension is becoming a major global burden of disease-causing millions of
deaths per year associated with cardiovascular disease. Although the occurrence of uncontrolled
BP differs globally and regionally, in low and middle-income countries, a growing burden of
uncontrolled BP is associated with low access to care and resources (Schutte et al., 2021).
Almost half of hypertensive adults worldwide are unaware of their condition, elevating their risk.
(CDC, 2025). This is a global issue, which contributes to the underdevelopment of multinational
and cross-culture strategies for blood pressure awareness and control. International screening,
education and standardized treatment protocols are important because hypertension is usually
"silent." The international nature of hypertension makes it clear that while the previous efforts to
3
address it through local interventions are very important, the international nature of the problem
requires coordination across health systems.
National Level
At the national level in the US, however, the prevalence of hypertension has remained
alarmingly high. According to data available for August 2021-August 2023, nearly 1 in 2 US
adults had hypertension (defined as >=130/80 mm Hg or on antihypertensive medication) at 47.7
percent (Fryar et al., 2024). The rates of awareness, treatment, and control remain below optimal
levels. For instance, only one-fifth of adults with hypertension achieved blood pressure control
below 130/80 mm Hg during the specified period. Racial and ethnic disparities persist: non-
Hispanic Black individuals experience higher rates of hypertension compared to non-Hispanic
White or Hispanic individuals (48.8 percent versus 37.6 percent and 27.9 percent, respectively)
and face challenges with controlling blood pressure (Sells et al., 2023). These disparities are
linked to socioeconomic status and educational accomplishment, and access to care. For
example, poverty and lower education are associated with cardiovascular disease, particularly in
Black and Hispanic adults. Given the prevalence, poor control, and inequities in control and
treatment, a national health promotion strategy targeting understanding, screening, access, and
control is clearly needed.
Local Level
At a more localized level, within the state of Florida, hypertension continues to pose a
significant concern with spatial and social segregation. A recent data set shows that 35.9 percent
of Florida adults reported having been told by a health professional that they had high BP.
(America’s Health Ranking, 2023). Among federally qualified health centers (FQHCs) in Florida
4
in 2017, the statewide average hypertension control rate was about 57 % with much lower
hypertension control rates (37.8 %-51.4 %) in the lowest tertile, occurring mostly in northern
Florida counties which also have higher rates of BP-related death (CDC, 2024). These data
characterize the communities of disparity within a single state: factors of geography,
socioeconomic, and access are at play in creating disparities. For a health-promotion endeavor in
Florida, targeting areas with low control rates as well as underserved populations and/or linkage
to primary care and community outreach would be directly relevant and warranted.
Conclusion
Given the widespread prevalence of hypertension around the world, as well as the high
prevalence of the condition in the United States as a whole, as well as the differences in
prevalence, control, and outcomes that are specific to the state of Florida, the argument in favor
of developing multilevel health promotion programs is persuasive. For programs to be
successful, they must be implemented on a global, national, and local scale. Several of the
promotion strategies have the potential to lessen the burden of hypertension and to reduce health
disparities. These strategies include addressing the social determinants of health, developing
greater access to screening and care, improving awareness and compliance, and tailoring the
intervention to the needs of populations that are underserved. Therefore, hypertension is a health
problem selection that is suitable for the construction of a health promotion program that will
span the global, national, and local levels, as well as the inequities that exist in the prevention
and control of the problem. Both of these levels will be addressed in the program.
5
References
America’s Health Ranking. (2023). Explore High Blood Pressure in Florida | AHR.
Americashealthrankings.org.
https://www.americashealthrankings.org/explore/measures/Hypertension/FL
CDC. (2024, August 28). Hypertension Control among Federally Qualified Health Centers
(FQHCs) and Hypertension Death Rates by County, Florida. Heart Disease and Stroke
Maps. https://www.cdc.gov/heart-disease-and-stroke-data/data-vis/fl-hypertension-
fqhc.html
CDC. (2025, January 28). High blood pressure facts. High Blood Pressure.
https://www.cdc.gov/high-blood-pressure/data-research/facts-stats/index.html
Fryar, C., Kit, B., Carroll, M., Afful, J., Warren, A., Zablotsky, B., Leadbetter, E., & Maitland,
A. (2024). Hypertension Prevalence, Awareness, Treatment, and Control among Adults
Ages 18 and Older:United States, August 2021—August 2023. NCHS Data Brief, 511.
https://doi.org/10.15620/cdc/164016
Goorani, S., Zangene, S., & Imig, J. D. (2024). Hypertension: A Continuing Public Healthcare
Issue. International Journal of Molecular Sciences, 26(1), 123–123.
https://doi.org/10.3390/ijms26010123
Schutte, A. E., Venkateshmurthy, N. S., Mohan, S., & Prabhakaran, D. (2021). Hypertension in
Low- and Middle-Income Countries. Circulation Research, 128(7), 808–826.
https://doi.org/10.1161/circresaha.120.318729
Sells, M., Blum, E., Perry, G. S., Eke, P. I., & Presley-Cantrell, L. (2023). Excess Burden of
Poverty and Hypertension, by Race and Ethnicity, on the Prevalence of Cardiovascular
Disease. Preventing Chronic Disease, 20(20). https://doi.org/10.5888/pcd20.230065
**## Forthisassignmentyouwillsubmit.docx**
For this assignment you will submit Part One of your proposal, detailing a health problem that is
prevalent within your selected group and demonstrating your research of health promotion strategies for
addressing this specific health problem. At this point, you already developed in your discussions the core ideas of the topic contained in this assignment. You will use the same information, but it won’t be a copy-and-paste exercise. The purpose is that you enhance your ideas with the comments and outcomes of the weekly discussions and previous evaluations.
Directions
1. Introduction. Describe the health problem. Don't type "Introduction". (1 paragraph at least).
Using data and statistics, support your claim that the issue you selected is a problem.
What specifically will you address in your proposed health promotion program?
Be sure your proposed outcome is realistic and measurable.
2. Describe the vulnerable population. (1-3 paragraphs).
What are the risk factors that make this a vulnerable population?
Use evidence to support the risk factors you have identified.
3. Provide a review of literature from scholarly journals (at least 2) of evidence-based interventions that address the problem. (2 paragraphs, one for each article).
After completing a literature search related to effective interventions for your chosen health promotion activity, write a review that evaluates the strengths and weaknesses of all the sources you have found. (2-3 paragraphs).
4. Select and present an appropriate health promotion/disease prevention theoretical or conceptual model that best serves as the guiding framework for the proposal. (2-3 paragraphs).
For this assignment, a conclusion paragraph is not required.
Writing Assignment Requirements
Three to five pages in length (excluding title page, references, and appendices)
Follow APA format
Cite a minimum of 6 references
Please review the rubric prior to submission.
**## HealthpromotionWeek2..pdf**
1
Health Problem Proposal: Hypertension and Health Disparities
Anisleidy Alvarez
Florida national University
Health Promotion & Role Development in Adv. Nursing Practice
Dr. Nora Hernandez-Pupo
November 8, 2025
2
Health Problem Proposal: Hypertension and Health Disparities
Hypertension is a widespread and extremely important public health problem given its
wide-ranging impact on cardiovascular morbidity and mortality. Hypertension can be
asymptomatic for many individuals, yet it plays a significant role in heart disease, stroke, kidney
failure, and other critical health conditions. Given its high prevalence and the fact that control is
still suboptimal, hypertension is a major burden to health systems and individual quality of life
(Goorani et al. 2024). Importantly, differences are present in the occurrence, recognition,
management, and regulation across racial/ethnic, socioeconomic, and geographic boundaries,
emphasizing the necessity for health promotion and prevention initiatives to address both clinical
health aspects and social determinants of health. The substantial health impact of hypertension
provides a rationale for the choice of this condition for implementation in a health promotion
program that addresses the issues of disparities at multiple levels.
Global Relevance
Globally, hypertension is becoming a major global burden of disease-causing millions of
deaths per year associated with cardiovascular disease. Although the occurrence of uncontrolled
BP differs globally and regionally, in low and middle-income countries, a growing burden of
uncontrolled BP is associated with low access to care and resources (Schutte et al., 2021).
Almost half of hypertensive adults worldwide are unaware of their condition, elevating their risk.
(CDC, 2025). This is a global issue, which contributes to the underdevelopment of multinational
and cross-culture strategies for blood pressure awareness and control. International screening,
education and standardized treatment protocols are important because hypertension is usually
"silent." The international nature of hypertension makes it clear that while the previous efforts to
3
address it through local interventions are very important, the international nature of the problem
requires coordination across health systems.
National Level
At the national level in the US, however, the prevalence of hypertension has remained
alarmingly high. According to data available for August 2021-August 2023, nearly 1 in 2 US
adults had hypertension (defined as >=130/80 mm Hg or on antihypertensive medication) at 47.7
percent (Fryar et al., 2024). The rates of awareness, treatment, and control remain below optimal
levels. For instance, only one-fifth of adults with hypertension achieved blood pressure control
below 130/80 mm Hg during the specified period. Racial and ethnic disparities persist: non-
Hispanic Black individuals experience higher rates of hypertension compared to non-Hispanic
White or Hispanic individuals (48.8 percent versus 37.6 percent and 27.9 percent, respectively)
and face challenges with controlling blood pressure (Sells et al., 2023). These disparities are
linked to socioeconomic status and educational accomplishment, and access to care. For
example, poverty and lower education are associated with cardiovascular disease, particularly in
Black and Hispanic adults. Given the prevalence, poor control, and inequities in control and
treatment, a national health promotion strategy targeting understanding, screening, access, and
control is clearly needed.
Local Level
At a more localized level, within the state of Florida, hypertension continues to pose a
significant concern with spatial and social segregation. A recent data set shows that 35.9 percent
of Florida adults reported having been told by a health professional that they had high BP.
(America’s Health Ranking, 2023). Among federally qualified health centers (FQHCs) in Florida
4
in 2017, the statewide average hypertension control rate was about 57 % with much lower
hypertension control rates (37.8 %-51.4 %) in the lowest tertile, occurring mostly in northern
Florida counties which also have higher rates of BP-related death (CDC, 2024). These data
characterize the communities of disparity within a single state: factors of geography,
socioeconomic, and access are at play in creating disparities. For a health-promotion endeavor in
Florida, targeting areas with low control rates as well as underserved populations and/or linkage
to primary care and community outreach would be directly relevant and warranted.
Conclusion
Given the widespread prevalence of hypertension around the world, as well as the high
prevalence of the condition in the United States as a whole, as well as the differences in
prevalence, control, and outcomes that are specific to the state of Florida, the argument in favor
of developing multilevel health promotion programs is persuasive. For programs to be
successful, they must be implemented on a global, national, and local scale. Several of the
promotion strategies have the potential to lessen the burden of hypertension and to reduce health
disparities. These strategies include addressing the social determinants of health, developing
greater access to screening and care, improving awareness and compliance, and tailoring the
intervention to the needs of populations that are underserved. Therefore, hypertension is a health
problem selection that is suitable for the construction of a health promotion program that will
span the global, national, and local levels, as well as the inequities that exist in the prevention
and control of the problem. Both of these levels will be addressed in the program.
5
References
America’s Health Ranking. (2023). Explore High Blood Pressure in Florida | AHR.
Americashealthrankings.org.
https://www.americashealthrankings.org/explore/measures/Hypertension/FL
CDC. (2024, August 28). Hypertension Control among Federally Qualified Health Centers
(FQHCs) and Hypertension Death Rates by County, Florida. Heart Disease and Stroke
Maps. https://www.cdc.gov/heart-disease-and-stroke-data/data-vis/fl-hypertension-
fqhc.html
CDC. (2025, January 28). High blood pressure facts. High Blood Pressure.
https://www.cdc.gov/high-blood-pressure/data-research/facts-stats/index.html
Fryar, C., Kit, B., Carroll, M., Afful, J., Warren, A., Zablotsky, B., Leadbetter, E., & Maitland,
A. (2024). Hypertension Prevalence, Awareness, Treatment, and Control among Adults
Ages 18 and Older:United States, August 2021—August 2023. NCHS Data Brief, 511.
https://doi.org/10.15620/cdc/164016
Goorani, S., Zangene, S., & Imig, J. D. (2024). Hypertension: A Continuing Public Healthcare
Issue. International Journal of Molecular Sciences, 26(1), 123–123.
https://doi.org/10.3390/ijms26010123
Schutte, A. E., Venkateshmurthy, N. S., Mohan, S., & Prabhakaran, D. (2021). Hypertension in
Low- and Middle-Income Countries. Circulation Research, 128(7), 808–826.
https://doi.org/10.1161/circresaha.120.318729
Sells, M., Blum, E., Perry, G. S., Eke, P. I., & Presley-Cantrell, L. (2023). Excess Burden of
Poverty and Hypertension, by Race and Ethnicity, on the Prevalence of Cardiovascular
Disease. Preventing Chronic Disease, 20(20). https://doi.org/10.5888/pcd20.230065
**## Forthisassignmentyouwillsubmit.docx**
For this assignment you will submit Part One of your proposal, detailing a health problem that is
prevalent within your selected group and demonstrating your research of health promotion strategies for
addressing this specific health problem. At this point, you already developed in your discussions the core ideas of the topic contained in this assignment. You will use the same information, but it won’t be a copy-and-paste exercise. The purpose is that you enhance your ideas with the comments and outcomes of the weekly discussions and previous evaluations.
Directions
1. Introduction. Describe the health problem. Don't type "Introduction". (1 paragraph at least).
Using data and statistics, support your claim that the issue you selected is a problem.
What specifically will you address in your proposed health promotion program?
Be sure your proposed outcome is realistic and measurable.
2. Describe the vulnerable population. (1-3 paragraphs).
What are the risk factors that make this a vulnerable population?
Use evidence to support the risk factors you have identified.
3. Provide a review of literature from scholarly journals (at least 2) of evidence-based interventions that address the problem. (2 paragraphs, one for each article).
After completing a literature search related to effective interventions for your chosen health promotion activity, write a review that evaluates the strengths and weaknesses of all the sources you have found. (2-3 paragraphs).
4. Select and present an appropriate health promotion/disease prevention theoretical or conceptual model that best serves as the guiding framework for the proposal. (2-3 paragraphs).
For this assignment, a conclusion paragraph is not required.
Writing Assignment Requirements
Three to five pages in length (excluding title page, references, and appendices)
Follow APA format
Cite a minimum of 6 references
Please review the rubric prior to submission.
**## HealthpromotionWeek2..pdf**
1
Health Problem Proposal: Hypertension and Health Disparities
Anisleidy Alvarez
Florida national University
Health Promotion & Role Development in Adv. Nursing Practice
Dr. Nora Hernandez-Pupo
November 8, 2025
2
Health Problem Proposal: Hypertension and Health Disparities
Hypertension is a widespread and extremely important public health problem given its
wide-ranging impact on cardiovascular morbidity and mortality. Hypertension can be
asymptomatic for many individuals, yet it plays a significant role in heart disease, stroke, kidney
failure, and other critical health conditions. Given its high prevalence and the fact that control is
still suboptimal, hypertension is a major burden to health systems and individual quality of life
(Goorani et al. 2024). Importantly, differences are present in the occurrence, recognition,
management, and regulation across racial/ethnic, socioeconomic, and geographic boundaries,
emphasizing the necessity for health promotion and prevention initiatives to address both clinical
health aspects and social determinants of health. The substantial health impact of hypertension
provides a rationale for the choice of this condition for implementation in a health promotion
program that addresses the issues of disparities at multiple levels.
Global Relevance
Globally, hypertension is becoming a major global burden of disease-causing millions of
deaths per year associated with cardiovascular disease. Although the occurrence of uncontrolled
BP differs globally and regionally, in low and middle-income countries, a growing burden of
uncontrolled BP is associated with low access to care and resources (Schutte et al., 2021).
Almost half of hypertensive adults worldwide are unaware of their condition, elevating their risk.
(CDC, 2025). This is a global issue, which contributes to the underdevelopment of multinational
and cross-culture strategies for blood pressure awareness and control. International screening,
education and standardized treatment protocols are important because hypertension is usually
"silent." The international nature of hypertension makes it clear that while the previous efforts to
3
address it through local interventions are very important, the international nature of the problem
requires coordination across health systems.
National Level
At the national level in the US, however, the prevalence of hypertension has remained
alarmingly high. According to data available for August 2021-August 2023, nearly 1 in 2 US
adults had hypertension (defined as >=130/80 mm Hg or on antihypertensive medication) at 47.7
percent (Fryar et al., 2024). The rates of awareness, treatment, and control remain below optimal
levels. For instance, only one-fifth of adults with hypertension achieved blood pressure control
below 130/80 mm Hg during the specified period. Racial and ethnic disparities persist: non-
Hispanic Black individuals experience higher rates of hypertension compared to non-Hispanic
White or Hispanic individuals (48.8 percent versus 37.6 percent and 27.9 percent, respectively)
and face challenges with controlling blood pressure (Sells et al., 2023). These disparities are
linked to socioeconomic status and educational accomplishment, and access to care. For
example, poverty and lower education are associated with cardiovascular disease, particularly in
Black and Hispanic adults. Given the prevalence, poor control, and inequities in control and
treatment, a national health promotion strategy targeting understanding, screening, access, and
control is clearly needed.
Local Level
At a more localized level, within the state of Florida, hypertension continues to pose a
significant concern with spatial and social segregation. A recent data set shows that 35.9 percent
of Florida adults reported having been told by a health professional that they had high BP.
(America’s Health Ranking, 2023). Among federally qualified health centers (FQHCs) in Florida
4
in 2017, the statewide average hypertension control rate was about 57 % with much lower
hypertension control rates (37.8 %-51.4 %) in the lowest tertile, occurring mostly in northern
Florida counties which also have higher rates of BP-related death (CDC, 2024). These data
characterize the communities of disparity within a single state: factors of geography,
socioeconomic, and access are at play in creating disparities. For a health-promotion endeavor in
Florida, targeting areas with low control rates as well as underserved populations and/or linkage
to primary care and community outreach would be directly relevant and warranted.
Conclusion
Given the widespread prevalence of hypertension around the world, as well as the high
prevalence of the condition in the United States as a whole, as well as the differences in
prevalence, control, and outcomes that are specific to the state of Florida, the argument in favor
of developing multilevel health promotion programs is persuasive. For programs to be
successful, they must be implemented on a global, national, and local scale. Several of the
promotion strategies have the potential to lessen the burden of hypertension and to reduce health
disparities. These strategies include addressing the social determinants of health, developing
greater access to screening and care, improving awareness and compliance, and tailoring the
intervention to the needs of populations that are underserved. Therefore, hypertension is a health
problem selection that is suitable for the construction of a health promotion program that will
span the global, national, and local levels, as well as the inequities that exist in the prevention
and control of the problem. Both of these levels will be addressed in the program.
5
References
America’s Health Ranking. (2023). Explore High Blood Pressure in Florida | AHR.
Americashealthrankings.org.
https://www.americashealthrankings.org/explore/measures/Hypertension/FL
CDC. (2024, August 28). Hypertension Control among Federally Qualified Health Centers
(FQHCs) and Hypertension Death Rates by County, Florida. Heart Disease and Stroke
Maps. https://www.cdc.gov/heart-disease-and-stroke-data/data-vis/fl-hypertension-
fqhc.html
CDC. (2025, January 28). High blood pressure facts. High Blood Pressure.
https://www.cdc.gov/high-blood-pressure/data-research/facts-stats/index.html
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