TABLE 2.

Socioecological Determinants of Hypertension Management Among Latinos Living in the U.S.–Mexico Border Region

Theme	Subtheme	Sample quotes
	Lack of safe exercise environments	We don’t have a place to walk here, you know. Most communities have a park where people gather and they can walk; we don’t.
	Lack of affordable food	The prices have doubled in the last year, the olive oil. The reason I buy the vegetable oil is because I buy the big one and then it’s like $5.98 and olive oil is a couple dollars more … The fruits and vegetables have gone up in price too.
		Well, yes, sometimes you have with what to buy but sometimes it becomes difficult to buy in large quantities, because the vegetables are expensive, all vegetables are very expensive.
	Trust/mistrust	What I would like is the doctors to be more humanist, that they could be doctors for vocation, any profession with vocation is very beautiful and very decent, a doctor without vocation doesn’t work. Well, I trust my doctor because she has been so human, so pretty, she explains, she asks, she does talk to you, she asks you what happens to you, how do you feel, and she puts a special attention on me that I have never received.
		My doctor told me I’m supposed to take it twice a day, but I only take it once a day ‘cuz I’m kind of afraid of the pill. It seems to me like they control me instead of me in control of the pill [laughter]. But I suppose I’m doing okay now. I’m still taking my pills every day.
	Quality of patient–provider communication	But a lot of people are afraid to communicate with their doctor or they don’t hear anything else. So. And I always tell everybody, “Take somebody else with you to your appointment, because you don’t hear everything that they’re telling you.”
		When I’ve gone sometimes to the doctor when they try, I know they’re busy. They try and scoot you out the door and not answer all the fully questions that you need to be answered.
		There’s no dialogue. It’s just “What do you have? What is your pain? Or what do you have? The ears, the nose or the eyes? Or this or the other …” and there, nothing …
		(No hay un diálogo. Éste … ¿qué tienes? ¿Qué te duele? O ¿qué tienes? O los oídos, la nariz, con los ojos, o esto o lo otro … y de allí nada ni …)
	Family as a social support	The only thing I can say is, my family keeps me going. My grandkids and my kids, because they have me going here, there, do this, do that. That’s what helps me.
		But uh, then I met my wife now, and she helped me out a lot. That is one of my biggest inner strengths is my wife. 42 years she stuck with me.
		Well, we exercise. We split the housework, cooking, doing the dishes, laundry, takes pressure off her to have this or that done. Get home in the evening, might do the laundry or I might fix the meal, do the dishes, days off I change sheets, make beds. It just lessens the workload on her, it makes it easier.
	Family as a source of stress	A lot of the families don’t know how to help you. I mean, they’re in the same, same you know, they’re in the same boat that we’re in. You know?
		I said [to my brothers and sisters], “Well, can’t you understand that this is a problem? A pill isn’t going to take care of it, you need to help bring her stress factors down, don’t call her and give her the woe-is-me I don’t have the money for this, or I don’t do this, or call and tell her, ‘I’m mad at my kids because they didn’t do this or that,’ or ‘So-and-so is saying’”—I tell them, “She’s far away enough, just call and say, ‘Mom, how are you?’ Don’t put any more weight.
	Cultural traditions	I think the hard part is the traditional, you know, what our families have shown us and stuff, I mean it’s just hard. I mean the tacos, the flautas, or tostadas. So all that, you know, and I mean, I’m so used to doing that, I don’t know. I mean I think it’s harder to try something different because I’m so used to the traditional stuff we have in our families.
		And then, like I’ve changed a lot of what I eat, but I still need to know the right way to cook. Because it’s very hard to have my family and they want to eat what I make, and that’s what makes it hard for me to you know. A lot of times, it’s a lot of fat. And that’s not good for the family. Yeah.
	Emotional burdens	You know, being stressed out, I know because I’ve been there. My grandma just passed … and we—me and my mom—took care of her 24/7.… And I went to the doctor because I have headaches, headaches, and more headaches.
		And I see that it’s a sadness … and in the afternoon it’s the same and I am sorry because I am so foolish because I don’t accept … that I only accept God’s will that I am human, and I tell you that one mourns one’s parents, one’s husband, hey, but mourning a son … no, there is no pain.… No, there is no bigger pain.
		See, that’s the way I think. If you’re going to dwell on something, it’s going to happen to you. And if you think negatively instead of so positive about what your health is, you’re going to, you’re going to get your health down. And I don’t think like that. I try and think positive thoughts.
		I also feel that if you have some kind of faith that you can cling on to, that helps. That helps a lot. Knowing there is some superpower over there that might listen to you. Just deep breathing, and exercises, breathing exercises, and there’s many little things we can do.
	Coping mechanisms	I think um, exercise itself will help relieve your stress. And it’s—not only your faith, but exercise, getting out. Not um, being at home all the time and worrying about your kids, worrying about your husband, worrying about the things at home, like getting out and just enjoying something that you really like to do.
		And so finally I calm myself down. Or I’ll take a long walk. And uh, if I need to go without him, just to work it out. And I come back, and I feel relieved. And if I’m driving or I’m walking, I’m praying, I’m talking to my dear lord, get me out of this, I’m okay.