“We don’t care because we are not sick”: understanding youths perceptions of hypertension in urban South Africa
“We don’t care because we are not sick”: understanding youths perceptions of hypertension in urban South Africa
Background
The growing burden of cardiovascular disease (CVD) in Sub-Saharan Africa (SSA) is largely driven by hypertension, with risk factors including poor diet, physical inactivity, tobacco use, psychological stress, and limited healthcare access. Early-life exposure to these risks contributes to adverse biological markers that increase hypertension susceptibility in adulthood. This study aimed to explore how young people in Soweto, Johannesburg, perceive hypertension risk, using the Health Belief Model (HBM) to understand their beliefs, attitudes, and barriers to prevention.
Methods
This study explored youth perceptions of hypertension in Soweto, Johannesburg, using focus group discussions (FGDs) with 62 participants aged 18–25, guided by the HBM. Thematic analysis was conducted to identify key beliefs, attitudes, and barriers to prevention.
Results
Participants largely underestimated their hypertension risk, perceiving youth as a protective factor and associating the condition primarily with older adults or those already diagnosed. While some acknowledged genetic predisposition, stress, and lifestyle factors as contributors, many saw hypertension as low severity and distant from their immediate concerns. Barriers to preventative action included social norms, stigma, financial constraints, and limited access to health-promoting resources. External cues, such as family influence and community awareness, were stronger motivators for behaviour change than personal risk assessment, while self-efficacy in adopting preventive behaviours was low.
Conclusion
Findings highlight a gap in youth awareness and engagement in hypertension prevention, driven by misperceptions of risk and limited access to enabling resources. Targeted interventions must address these misconceptions, enhance perceived severity, and leverage community and familial influences to promote early prevention and sustained behaviour change.
Cardiovascular disease, Health Belief Model, Hypertension, Precision prevention, Preventative health strategies, Public health, South Africa, Soweto, Youth perceptions
Samakosky, Madeleine J.
92199c75-b77f-4f62-b0dc-d93f28584c11
Crouch, Simone H
5664c146-6ab8-4c8f-8925-15b3f86d2a02
Norris, Shane A.
1d346f1b-6d5f-4bca-ac87-7589851b75a4
5 August 2025
Samakosky, Madeleine J.
92199c75-b77f-4f62-b0dc-d93f28584c11
Crouch, Simone H
5664c146-6ab8-4c8f-8925-15b3f86d2a02
Norris, Shane A.
1d346f1b-6d5f-4bca-ac87-7589851b75a4
Samakosky, Madeleine J., Crouch, Simone H and Norris, Shane A.
(2025)
“We don’t care because we are not sick”: understanding youths perceptions of hypertension in urban South Africa.
BMC Public Health, 25 (1), [2657].
(doi:10.1186/s12889-025-23729-6).
Abstract
Background
The growing burden of cardiovascular disease (CVD) in Sub-Saharan Africa (SSA) is largely driven by hypertension, with risk factors including poor diet, physical inactivity, tobacco use, psychological stress, and limited healthcare access. Early-life exposure to these risks contributes to adverse biological markers that increase hypertension susceptibility in adulthood. This study aimed to explore how young people in Soweto, Johannesburg, perceive hypertension risk, using the Health Belief Model (HBM) to understand their beliefs, attitudes, and barriers to prevention.
Methods
This study explored youth perceptions of hypertension in Soweto, Johannesburg, using focus group discussions (FGDs) with 62 participants aged 18–25, guided by the HBM. Thematic analysis was conducted to identify key beliefs, attitudes, and barriers to prevention.
Results
Participants largely underestimated their hypertension risk, perceiving youth as a protective factor and associating the condition primarily with older adults or those already diagnosed. While some acknowledged genetic predisposition, stress, and lifestyle factors as contributors, many saw hypertension as low severity and distant from their immediate concerns. Barriers to preventative action included social norms, stigma, financial constraints, and limited access to health-promoting resources. External cues, such as family influence and community awareness, were stronger motivators for behaviour change than personal risk assessment, while self-efficacy in adopting preventive behaviours was low.
Conclusion
Findings highlight a gap in youth awareness and engagement in hypertension prevention, driven by misperceptions of risk and limited access to enabling resources. Targeted interventions must address these misconceptions, enhance perceived severity, and leverage community and familial influences to promote early prevention and sustained behaviour change.
Text
s12889-025-23729-6
- Accepted Manuscript
More information
Accepted/In Press date: 24 June 2025
Published date: 5 August 2025
Additional Information:
Publisher Copyright:
© The Author(s) 2025.
Keywords:
Cardiovascular disease, Health Belief Model, Hypertension, Precision prevention, Preventative health strategies, Public health, South Africa, Soweto, Youth perceptions
Identifiers
Local EPrints ID: 503974
URI: http://eprints.soton.ac.uk/id/eprint/503974
ISSN: 1471-2458
PURE UUID: ad7cd52c-5628-44c3-bc4a-02cece6a7011
Catalogue record
Date deposited: 19 Aug 2025 17:05
Last modified: 22 Aug 2025 02:27
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Contributors
Author:
Madeleine J. Samakosky
Author:
Simone H Crouch
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