Abstract
Purpose
This study aimed to assess the prevalence of hypertension and diabetes among laundromat users in San Antonio, Texas, and explore laundromats as a novel setting for health interventions regarding these 2 conditions.
Design
This descriptive, cross-sectional study involved demographic, blood pressure and HbA1c screenings to assess the health status of laundromat users.
Setting
The study took place in 7 laundromats in low-income areas of San Antonio.
Subjects
A total of 150 adults aged 18 and older who regularly used the laundromats and spoke either English or Spanish were eligible to participate.
Measures
Hypertension was defined as a systolic BP ≥130 mmHg and/or diastolic BP ≥80 mmHg. Diabetes was defined as an HbA1c level ≥6.5%. A survey collected demographic and healthcare access data.
Results
61.1% (95% CI: 53.0%-68.6%) of participants screened positive for hypertension, significantly higher than county (31.1%), state (32.3%), and national (32.7%) rates (P < .001). The prevalence of diabetes was 14.1% (95% CI: 8.7%-21.1%), slightly higher than Bexar County (10.2%) and national (8.4%) rates, though not statistically significant. Gender and the number of children in the household were significantly associated with hypertension and diabetes, respectively.
Conclusion
Laundromats can effectively serve as sites for health screening and interventions for hypertension and diabetes, offering a unique opportunity to reach underserved populations and address health disparities.
Keywords
Purpose
Hypertension and diabetes are major contributors to mortality and chronic disease burden, yet education and regular health monitoring have been shown to improve outcomes and prevent complications.1-3 Place-based interventions provide preventative care in unconventional settings, such as barbershops and grocery stores, to increase health service access for underserved communities. 4 However, few studies have explored laundromats as intervention sites, despite their potential to reach individuals with limited healthcare access. 5 This study was conducted in San Antonio, Texas, the largest Hispanic-majority city in the United States, offering a unique opportunity to examine a population often underrepresented in place-based health intervention research. 6
This study examined the prevalence of hypertension and diabetes among laundromat users and identified demographic risk factors associated with these conditions. While the burden of chronic disease in low-income populations is well established, the practical application of delivering point-of-care screening in everyday community environments like laundromats has not been widely evaluated. 3 This study builds on prior work to assess whether laundromats serve as feasible and effective locations for offering preventative healthcare services to underserved populations. Findings provide insight into the feasibility of laundromats as venues for point-of-care screening and place-based health services.
Methods
Design
A cross-sectional study was conducted in 7 laundromats in low-income areas of San Antonio, Texas, from March to October 2024. Study procedures were approved by the institutional review board.
Sample
Participants (N = 150) were included in the study if they were 18 or older and spoke English or Spanish. Participants were recruited from flyers and engagement at 1 of 7 laundromats. A $10 gift card was provided for participation.
Measures
Blood pressure was assessed with an Omron Blood Pressure Monitor, defining hypertension as systolic ≥130 mmHg or diastolic ≥80 mmHg. 7 Hemoglobin A1c was measured using a Siemens DCA Vantage Analyzer, with diabetes defined as A1c ≥6.5%. 8 Sociodemographic and healthcare access data were collected via survey and adopted from the Texas Behavioral Risk Factor Surveillance System (BRFFS). 9
Analysis
Descriptive statistics and chi-square tests examined associations between sociodemographic characteristics and health conditions. One-sample z-tests compared laundromat findings with county, state, and national prevalence rates using data from the Centers for Disease Control and Prevention (CDC) PLACES Project, the Behavioral Risk Factor Surveillance System (BRFSS), and the CDC Diabetes Surveillance System.10-12
Results
A Comparison Between Laundromat Customer, Bexar County, Texas, and National Rates of Hypertension and Diabetes
Note. *P < .05, **P < .01, ***P < .001.
Sociodemographic Characteristics by Health Outcomes Among Laundromat Customers: Hypertension and Diabetes
Note. *P < .05, **P < .01, ***P < .001.
Discussion
Summary
This study highlights laundromats as promising sites for point-of-care screening, with strong potential for future interventions targeting chronic disease prevention and management. The disproportionately high prevalence of hypertension among laundromat users underscores the need for accessible screening and intervention services. While diabetes prevalence was not significantly different from county and national rates, laundromats still provide a strategic venue for preventative care and health education.
Limitations
The significant association between hypertension and male sex aligns with existing research, while the link between diabetes and having multiple children may reflect socioeconomic stressors impacting diet, healthcare access, and disease management. 13 Most demographic variables had a small proportion of missing data due to participants selecting ‘prefer not to answer’ in the survey, which was most common for sexuality (11%) and household income (24.1%) variables. Additionally, a small number of participants declined blood pressure and/or A1c screenings and were excluded from their respective analyses. While this approach preserved participant autonomy, it may have introduced selection bias.
Significance
Limitations include the reliance on screening rather than clinical diagnoses, potential selection bias, and missing survey data.
14
Future studies should explore sustainable intervention models and broader demographic comparisons. Place-based interventions in barbershops and salons have successfully increased access to preventative healthcare, but limited research exists on laundromats as intervention sites.4 This study demonstrates that laundromats serve a population with high hypertension prevalence and healthcare access barriers, highlighting their potential as health intervention venues. Health screenings in laundromats could enhance early detection of chronic conditions. Integrating interventions such as nutrition education, pharmacy services, or vaccinations could further improve health outcomes in underserved communities.SO What?
What is Already Known on This Topic?
What Does This Article Add?
What are the Implications for Health Promotion Practice or Research?
Footnotes
Ethical Considerations
The institutional review board approved all study procedures at the University of Texas Health Science Center at Houston (HSC-SPH-21-0392).
Consent to Participate
To participate, individuals read an electronic informed consent form using an electronic device. All participants provided verbal consent before starting the survey. Consent forms were available in English and Spanish to all participants.
Consent for Publication
The digital informed consent that was provided to all participants informed them aggregate data may be published.
Author Contributions
N. McCann and J. Tsai designed the study. N. McCann helped collect and analyze the data. V. Schick helped conceptualize the study and analyze the data. All authors contributed to interpreting the results and writing the manuscript. All authors read and approved the final manuscript.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data Availability Statement
Data generated for this project are not publicly available because they are part of ongoing research but are available from the last author on reasonable request with proper approval by the institutional review board.