Analysis of refugee mental health screening and referral processes at the Newcomers Health Program, San Francisco General Hospital’s Refugee Medical Clinic: a quality improvement study

: 1.026_NEP Hypertension prevalence in Zanskar, India: a study to guide future health interventions in rural health clinics M. Chan, W. Tsai, M. Dai; New York University School of Medicine, New York, NY, USA Background: Zanskar, India is a high-altitude, remote region located near the Himalayan mountain range in Ladakh, in northern India. Due to its isolation, much of the population, especially in the farming villages, lack access to regular medical care. The aim of the study was to assess the prevalence of hypertension and to consider risk factors specific to this population. Methods: Data was collected from 318 patients aged 20 to 90 years who presented at temporary medical camps in the villages of Sani and Raru in July 2015. Patients had their blood pressure measured twice and the mean systolic and diastolic pressures were calculated. Through a translator, patients completed a questionnaire about their knowledge of their medical conditions and lifestyle risk factors. The population was stratified by age and gender and then categorized by their blood pressure status. Findings: Of the 318 patients we surveyed, 33% were pre-hypertensive and 25% were hypertensive, with 60% of that group unaware of their hypertension status. 90% of patients who were aware of their hypertension were not taking medications at the time of presentation to the clinic. The prevalence of hypertension increased with age while the prevalence of prehypertension remained relatively stable at all surveyed age groups. At 36%, the prevalence of hypertension for men was higher than that for women (21%). Men also had a higher prevalence of prehypertension (40%) than that of women (30%). Interpretation: The prevalence of hypertension is relatively high in the two villages in Zanskar, India, indicating that hypertension is not limited to urban Westernized populations and can also affect isolated, rural populations. More thorough epidemiological studies should be conducted to identify specific risk factors in other parts of Ladakh. We believe that cultural, socioeconomic, and geographical factors likely greatly influence hypertension risks in Zanskar. Our findings suggest that future interventions in similar populations should prioritize hypertension as a serious public health issue. Funding: New York University School of Medicine, International Health Program. Abstract #: 1.027_NEP: 1.027_NEP Analysis of refugee mental health screening and referral processes at the Newcomers Health Program, San Francisco General Hospital’s Refugee Medical Clinic: a quality