# Addressing Hypertension Disparities: Make Care Reachable

Equity work becomes actionable when a specific barrier is connected to a completed care change and outcomes are checked for those most often missed.

![Infographic: Addressing Hypertension Disparities: Make Care Reachable](https://urinenephrology.org/visual-reference/images/lesson-health-disparities.png?v=20261003c)

## Find where care is being lost

Separate missed diagnosis, medication access, refill gaps, missed visits, and persistent uncontrolled BP. Include people without recent measurements in the denominator; excluding them can make apparent control improve while access worsens. Use local data to identify the part of the pathway that needs repair.

## Ask the patient for the barrier

Ask about cost, transport, work, caregiving, food, language, housing, and previous treatment experiences without assuming the answer from race or income. A patient rationing pills needs a different intervention from one whose cuff is inaccurate or whose medication causes dizziness.

## Match support to the problem

For cost, reconcile coverage and confirm an affordable prescription was obtained. For language, use appropriate interpretation and teach-back. For transport or work conflicts, offer a feasible visit or monitoring method. A list of resources is incomplete until the connection actually occurs.

## Learn the whole community model

The Black barbershop trial paired a trusted setting with pharmacist-led medication management and coordination, showing sustained BP improvement. It did not test screening posters alone. When adapting the model, preserve reliable measurement, prescribing responsibility, safety monitoring, and follow-up rather than copying only the venue.

## Make technology an option, not a gate

Home monitoring can reduce travel but create device, connectivity, literacy, or dexterity barriers. Offer a validated cuff and training when possible, with phone or paper alternatives. Assign the same clinical response pathway regardless of how a reliable reading reaches the team.

## Check benefit and burden by group

Track control, refill continuity, follow-up completion, side effects, and patient costs across relevant groups. Investigate who declines or disappears from the program. An overall mean BP improvement does not establish equitable benefit; modify the process with patients when gaps persist.

## Supporting evidence

- [Sustainability of Blood Pressure Reduction in Black Barbershops.](https://pubmed.ncbi.nlm.nih.gov/30592662/)
- [Team-based care and improved blood pressure control: a community guide systematic review.](https://pubmed.ncbi.nlm.nih.gov/24933494/)
- [Digital Health Approaches for the Assessment and Optimisation of Hypertension Care Provision.](https://pubmed.ncbi.nlm.nih.gov/33340672/)

## Source lessons

- [health disparities](https://urinenephrology.org/2025_UDPA_Lectures_Live/hypertension/health-disparities.html)

Read alongside the full lessons; the findings and decisions shown here require the stated clinical context.