Nigerian civil servants . John Henryism and blood pressure among

Study objective—Among urban Nigerian civil servants, higher socioeconomic status is related to increased blood pressure. In the United States, the relation between increased blood pressure and low socioeconomic status or low level of education has been found to be potentiated by high eVort active coping (John Henryism) among African-Americans. Thus, the potentiating eVect of high eVort active coping as measured by the John Henryism Active Coping Scale, on socioeconomic status, as measured by job grade, was considered in relation to blood pressure in a Nigerian civil servant population. Design—The influence of John Henryism on the association between educational level or socioeconomic status and increased blood pressure was examined during a comprehensive blood pressure survey. John Henryism refers to a strong behavioural predisposition to actively cope with psychosocial environmental stressors. Setting—Benin City, Nigeria. Participants—Nigerian civil servant sample of 658 adults, aged 20 to 65 years. Main results—Among those with high John Henryism scores of upper socioeconomic status, whether measured by education level or job grade, there was a trend toward higher systolic and diastolic blood pressures, adjusted for age and body mass index, in men and women, though not statistically significant. Conclusions—This trend is consistent with recent findings of increased blood pressure among women and AfricanAmericans with high John Henryism and high status jobs. (J Epidemiol Community Health 1998;52:186–190) Increased blood pressure has been seen to be associated with a number of physical, sociodemographic, and psychological factors. Numerous epidemiological studies have found socioeconomic status to be inversely related to increased blood pressure among populations in European countries and the United States. Among African-Americans residing in the United States, the relation is thought to be influenced, in part, by a coping strategy called “John Henryism”. John Henryism has been defined as a strong behavioural predisposition to cope in an active, determined, and hardworking manner with the stressors of everyday life. The influence is such that among African-Americans of low socioeconomic status or of low educational attainment, those with high John Henryism scores show increased blood pressure or increased prevalence of hypertension. This finding has also been confirmed in a white Dutch population. More recently, high John Henryism has also been found to potentiate an association between high job status and blood pressure among women and African-Americans employed in the United States. However, the combination of high John Henryism and low education was not associated with increased blood pressure in a young cohort (18–30 year olds). Among civil servants in Nigeria, we have observed a positive association between blood pressure and socioeconomic status, with increased blood pressure measurements among those of higher staV status. During our most recent comprehensive blood pressure survey of civil servants in Benin City, Nigeria, we used the John Henryism Active Coping Scale to examine its application in this non-Westernised population.We wanted to replicate the analyses of James et al, that is, to test the hypothesis that those with lesser material coping resources (for example, lower educational attainment, lower job grade) who scored high on the John Henryism Active Coping Scale, would have increased blood pressure. Alternatively, we sought to examine whether or not this measure of active coping further explained our previous finding of increased blood pressure among those of higher staV status. Methods We recruited 84% of the civil servants at three ministries of Edo State in Benin City, Nigeria, for participation in a comprehensive blood pressure survey. This population has been previously described and is characterised as a lean population with a low protein and fat intake, moderate sodium intake, and a very low rate of smoking. These analyses are restricted to the 658 (81.3%) of the 809 civil servants, between the ages of 20 and 65 years, who completed the John Henryism Active Coping Scale. Administration of the John Henryism Active Coping Scale was begun after the start of study data collection, thus the first 151 participants did not complete the John Henryism Active Coping Scale. Each individual was seen at three morning appointments scheduled over one week at the study site located in each of the respective ministries. At each of the three visits, three blood pressure determinations were made by Nigerian study team members, certified by a standard protocol. First and fifth KorotoV sounds were recorded as systolic and J Epidemiol Community Health 1998;52:186–190 186 Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA