Both social and psychosocial factors are associated with cardiovascular health in US adults, and significant differences between racial and ethnic groups persist within the population.
New research published in American Heart Association Science Session 2022 In Chicago, we showed that education and place of birth each contributed statistically significantly to differences in cardiovascular health between racial and ethnic groups.
“Overall, given the significant association between CVH and developing cardiovascular disease (CVD), the individual-level factors studied statistically contribute to racial and ethnic differences in CVH. suggested that these social and psychosocial determinants may contribute to racial and ethnic differences in CVD incidence in the US population.”, study author Nilay S. Shah, MD, MPH Department of Preventive Medicine, Northwestern University Feinberg School of Medicine writes:
Because race and ethnicity exist as social constructs, not biological ones, underlying social and structural determinants of health account for differences in cardiovascular disease (CVD) risk among different groups. could be.
Clinical and behavioral factors were summarized in the American Heart Association’s Life’s Simple 7 CVH Score, which included diet quality, smoking, physical activity, body mass index (BMI), blood pressure, cholesterol, and blood glucose levels.
Investigators are from the National Health and Nutrition Examination Survey (NHANES) between 2011 and 2018.
The sample consisted of non-institutionalized adults aged 20 years or older who participated in a Mobile Examination Center (MEC) trial. Composite CVH scores ranged from 0 to 14 and were calculated as the sum of points in seven categories, with higher scores indicating she had better CVH.
Individual-level factors associated with CVH and CVD were further measured, including educational attainment, food insecurity, health insurance, depression, and participants’ place of birth. The Kitagawa-Blinder-Oaxaca (KBO) decomposition was used to identify race and We statistically quantified the amount of mean CVH difference between ethnic groups. Magnitude of association between individual-level factors and CVH within each racial and ethnic group.
Of the 16,172 NHANES participants, representing 255 million U.S. adults, 7,969 were male, including 24% Hispanic, 12% non-Hispanic Asian, 23% non-Hispanic black, 41% were non-Hispanic white. Women were 8,203, of which 25% were Hispanic, 12% were non-Hispanic Asian, 23% were non-Hispanic black, and 40% were non-Hispanic white.
Mean CVH scores for male participants ranged from 7.45 for Hispanic adults, 7.48 for non-Hispanic black adults, 7.58 for non-Hispanic white adults, and 8.71 for non-Hispanic Asian adults.
Mean CVH scores for female participants were 8.03 for Hispanic adults, 9.34 for non-Hispanic Asian adults, 7.43 for non-Hispanic black adults, and 8.00 for non-Hispanic white adults.
In the KBO decomposition, education was focused on to explain the largest component of CVH differences between males. The data show that if the distribution of education was similar to non-Hispanic white adults, CVH scores were 0.36 points higher for Hispanic adults, 0.24 points lower for non-Hispanic Asian adults, and 0.23 points higher for non-Hispanic black adults. is showing. P. <.05).
Furthermore, the findings suggest that education explained the largest component of CVH differences among non-Hispanic black women. If a non-Hispanic black woman had the same educational distribution as a non-Hispanic white woman, her mean CVH score would be significantly higher by 0.17 points (P. < .05).
According to the researchers, an individual’s place of birth (US-born vs. non-US-born) explained the greatest factor in the difference in CVH between Hispanic and non-Hispanic Asian women. CVH scores are 0.36 and 0.49 points lower, respectively, when the birthplace distribution is similar to non-Hispanic white women (P. <.05).
Individual-level factors contributed minimally to the unexplained component of mean CVH differences.
“Our findings are intended to form the basis for potential community- and population-level interventions and policies to address differences and disparities in CVH,” Shah said. Future studies with longitudinal data that allow for mediated analysis will complement our findings on the role of social and psychosocial factors in racial and ethnic differences in CVH.”
The study “Social and Psychosocial Determinants of Racial and Ethnic Differences in Cardiovascular Health in the U.S. Population” circulation.
