Perceptions on hypertension among migrants in Delhi, India: a qualitative study

BACKGROUND: The developing countries are experiencing epidemiological transition and hypertension has emerged as a major threat to health in these countries. Understanding people's perceptions is important for any prevention and control activities and lay explanatory models (EMs) provide an opportunity to gain insights into the people's perceptions. This qualitative study is taken up with an objective of understanding EMs of neo- and settled-migrants regarding hypertension. METHODS: Qualitative methods with grounded theory approach were used to elicit EMs of hypertension held by neo- and settled-migrants. In-depth interviews with key-informants and focus group discussions with community members were conducted. The data were subjected to thorough reading and analysed by segregating the text under different themes. RESULTS: Hypertension has been perceived as a common and serious problem in the community. Lay conceptions have identified hypertension as symptomatic with ambiguity over perceived symptoms. City life has been perceived as a major predisposing factor for developing hypertension. City life has been corroborated with pollution and adulteration of food, stress, high fat diet along with physical inactivity and certain attitudes. The concepts of hypertension were interconnected and linked to their day-to-day living in the city. Inadequacy of awareness has been acknowledged and there was a felt need for awareness campaigns and screening programmes in the community. The EMs of hypertension among the neo- and settled-migrants and men and women were broadly similar. However, there were slight variations by gender and migration status in the perceived pathways to hypertension. CONCLUSION: Hypertension has been perceived as a common and serious problem in the community. Hypertension has been perceived as symptomatic; however, ambiguity prevails over perceived symptoms. Awareness and knowledge about hypertension and its consequences are inadequate in these communities. The felt need for awareness campaigns and mass screening programmes has emerged from the community and it provides enabling environment to successfully carry out public health interventions, by addressing the existing gaps, for prevention and control of hypertension and other cardiovascular diseases.