Abstract MP61: Comparing the Influence of Individual vs. Community Socioeconomic Factors on Cardiovascular Health

BACKGROUND: Despite advances in treatment and decreases in risk factors, cardiovascular disease remains the cause of 1/3 deaths. Both prevalence and cost of cardiovascular disease are expected to increase over the coming decades. In supporting health efforts to reduce cardiovascular disease burden, the AHA developed a comprehensive cardiovascular health index (CVHI) incorporating behavioral and biological factors. A thorough understanding of health determinants requires inclusion of factors at multiple levels of proximity to individuals and communities. The objective of this study was to identify the demographic characteristics of individuals and areas in which they live that promote cardiovascular health. METHODS: Data from 2011 BRFSS were used to calculate CVHI. Participants were ineligible if missing information necessary to calculate CVHI (n = 156,973), if pregnant or pregnancy status was unknown (n = 3,693), or if missing county code (n = 37,163). Poisson model was used to determine change in the expected number of ideal factors an individual had due to various individual and county demographic characteristics. County demographic variables were abstracted from the Area Health Resource File. RESULTS: The effect of a 10 year increase in an individual’s age decreased the expected number of ideal CVHI factors by 6.31% (6.14, 6.47). Females had a 12.09% (11.48, 12.70) increase in expected number of ideal CVHI factors over males. Non-Hispanic blacks had a 7.42% (6.39, 8.44) decrease in expected number of ideal CVHI factors compared to other race/ethnicities. An individual’s education and income level had a dose response association with CVHI. Compared to having less than a high school education, those with a high school education had a 5.15% increase in the expected number of ideal CVHI factors and an 11.64% increase for those with a 4 year degree. As an individual’s income category increased there was a 7.89%, 10.79%, and 16.34% increase respectively in the expected number of ideal CVHI factors. For county demographics increases in the expected number of ideal factors was seen with increases in Hispanic population (0.93% per 10% increase) and increasing socioeconomic index (0.14% per 10 unit increase). A 10% increase in the population with no health insurance decreased the expected number of factors 1.49% (0.75, 2.22). There was a significant interaction (p <0.01) between an individual’s income level and the socioeconomic status of the county lived in, with those in lower income categories benefiting more from living in higher socioeconomic areas than those with higher incomes. In conclusion, both individual and county demographic characteristics were associated with changes in an individual’s CVHI. CONCLUSION: This information can assist public health and government agencies in developing priorities and evaluating the potential effectiveness of policies and programs.

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Examining preference of elderly for adding indication to the prescription label (Rx Label)

European Journal for Person Centered Healthcare ◽

10.5750/ejpch.v2i4.844 ◽

2014 ◽

Vol 2 (4) ◽

pp. 523

Author(s):

Prashant Sakharkar ◽

Amir Zargarzadeh ◽

Anandi Law

Keyword(s):

High School ◽

Prescription Medication ◽

The Elderly ◽

Demographic Characteristics ◽

School Education ◽

High School Education ◽

Chi Square ◽

Convenience Sample ◽

Exact Test ◽

Daycare Centers

Rationale and aim To examine preference of the elderly for adding indication (medication use/purpose) to prescription label, reasons for their preference and its association with demographic characteristics. Methods A convenience sample of 143 patients of age 65 or older, who took at least one prescription medication every day were interviewed using a structured questionnaire. The data were analyzed for descriptive statistics, correlation for demographic characteristics with participant’s preference for adding indication to prescription label using the Chi-square and Fisher’s exact test. Regression analysis was conducted to predict participant’s preference. Results Participants were ethnically diverse, majority being female (60.8%), with average age of 76.9 yrs. Twenty nine percent participants had more than high school education. About 91% participants preferred adding indications to their prescription label for the reasons: “managing medication by category” (29%), “distinguishing medications” (69%), and “reducing confusion” (29%). Adult daycare centers and community pharmacy participants with lower than high school education showed higher preference for adding indication for reducing confusion and distinguishing medication, respectively. Whereas, Hispanic/Latino participants of adult daycare centers preferred for the reason, distinguishing medications (p<0.05). Age, race/ethnicity and education were found to be good predictors of their preference. Conclusion The elderly showed higher preference for adding indication to the prescription label for improving their ability to distinguish medications and reduce confusion. Our results suggest a need for adopting recently released USP patient-centered prescription label standards, which also include adding indication to the Rx labels.

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Abstract P473: Social Determinants of Cardiovascular Health Among Afro-Caribbean Immigrants in New York City

Circulation ◽

10.1161/circ.141.suppl_1.p473 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Sabena Thomas ◽

Amna Umer ◽

Yvonne Commodore-mensah ◽

Danielle Davidov ◽

Christiaan Abildso

Keyword(s):

High School ◽

New York ◽

New York City ◽

Social Determinants ◽

York City ◽

Cardiovascular Health ◽

College Education ◽

School Education ◽

High School Education ◽

Black Immigrants

Introduction: Research on cardiovascular health (CVH) and risk factors among immigrants has been well-documented. Less is known about social influences on CVH, among black immigrants. Despite having the largest population of black immigrants in the U.S., Afro-Caribbean (AC) immigrants have been underrepresented in health research. We examined the social determinants of CVH among AC immigrants (Guyanese, Haitian and Jamaican) in New York City (NYC). Hypothesis: We hypothesized that social determinants of CVH will vary among the three ethnic sub-groups of AC immigrants. Methods: We included 1691 AC immigrants who reported their race as non-Hispanic Black and country of birth (COB) as Guyana (n= 369), Haiti (n= 291) or Jamaica (n= 1031) in the 2010-2014 administrations of the New York City Community Health Survey. Logistic regression analysis was performed to assess the association between social determinants and CVH (ideal vs intermediate/poor) using AHA’s CVH metrics. Results: The majority of the sample was female (59.2%) and reported high school education or less (53.9%). Most AC immigrants reported to have ideal CVH (71.3%). Education was significantly associated with CVH only among Jamaican immigrants. Jamaican immigrants with ≤ high school education were more likely to have intermediate/poor CVH compared to those with ≥ some college education. Conclusions: These findings suggest that social determinants influencing CVH differ among AC immigrant sub-groups in NYC. These findings suggest that social determinants influencing CVH differ among AC immigrant sub-groups in NYC. National surveillance efforts should obtain more complete data on country of origin and oversample racial/ethnic minority groups in order to better understand their CVH outcomes. Future research should examine other social factors that may influence CVH among black immigrants.

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DEMOGRAPHIC CHARACTERISTICS AND BODY MASS INDEX IN OBESE ADOLESCENTS

Jurnal Berkala Epidemiologi ◽

10.20473/jbe.v7i32019.189-196 ◽

2019 ◽

Vol 7 (3) ◽

pp. 189

Author(s):

Nur Aisyah Widjaja ◽

Rendi Aji Prihaningtyas ◽

Meta Herdiana Hanindita ◽

Roedi Irawan

Keyword(s):

High School ◽

Body Mass Index ◽

Body Mass ◽

Maternal Education ◽

Intima Media Thickness ◽

Demographic Characteristics ◽

School Education ◽

High School Education ◽

Cross Sectional ◽

Obese Adolescents

Background: The prevalence of adolescent obesity is increasing in Indonesia. Obesity can reduce the quality of life, especially as most obese adolescents remain obese after they become adult. In obese adolescents, the higher their IMT (intima-media thickness), the higher the risk of cardiovascular disease in adulthood. Purpose: The aim of this study is to analyse the correlation of demographic characteristics with BMI (body mass index) in adolescents with obesity. Methods: This study is a cross-sectional study on adolescents with obesity conducted in the Paediatric Nutrition and Metabolic Disease Clinic of Dr Soetomo General Hospital, Surabaya. The data on demographic characteristics, such as gender, number of siblings, paternal education, maternal education, and maternal occupation, were collected using the interview method. Data on anthropometry were collected to calculate BMI. Obesity is established if it is higher than the 95th percentile, based on CDC percentile of BMI, according to age and sex. Data were analysed using multiple regression. Results: A total of 59 obese adolescents, between 13 and 16 years old, were involved. As many as 49.20% of respondents had one sibling. As many as 52.50% of respondents had a father with a high school education and 44.10% of respondents had mothers with a high school education; 61% of respondents had working mothers. There was no correlation between BMI and demographic characteristics (p> 0.05), except for number of siblings (p = 0.02). Conclusion: In this study, the number of siblings was correlated with BMI. A study with a greater number of obese adolescents and with adolescents who have normal nutritional status is needed to fully assess the influence of demographic characteristics on BMI in obese adolescents.

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Do social inequalities in smoking differ by immigration status in young adults?

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.831 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

J Kalubi ◽

Z Tchouaga ◽

A Ghenadenik ◽

J O'Loughlin ◽

K L Frohlich

Keyword(s):

High School ◽

Young Adults ◽

Vocational Training ◽

Social Inequalities ◽

Preventive Intervention ◽

School Education ◽

High School Education ◽

Social Gradient ◽

Current Smoking ◽

The Difference

Abstract Background Tobacco use accounts for half the difference in life expectancy across groups of low and high socioeconomic status. The objective was to assess whether social inequalities in smoking in Canada-born young adults are also apparent among same-age immigrants, a group often viewed as disadvantaged and vulnerable to multiple health issues. Methods Data were drawn from the Interdisciplinary Study of Inequalities in Smoking, a longitudinal investigation of social inequalities in smoking in Montreal, Canada. The sample included 2,077 young adults age 18-25 (56.6% female; 18.9% immigrants). Immigrants had been in Canada 11.6 (SD 6.4) years on average. The association between level of education and current smoking was examined separately in immigrants and non-immigrants in multivariate logistic regression analyses controlling for covariates. Results Twenty percent of immigrants were current smokers compared to 24% of non-immigrants. In immigrants, relative to those who were university-educated, the adjusted odds ratio (OR) (95% confidence interval) for current smoking was 1.2 (0.6, 2.3) among those with pre-university or vocational training, and 1.5 (0.7, 2.9) among those with high school education only. In non-immigrants, the adjusted ORs were 1.9 (1.4, 2.5) among those with pre-university or vocational training and 4.0 (2.9, 5.5) among those with high school education. Conclusions Despite a mean of over 10 years in Canada, young adults who immigrated to Canada did not manifest the strong social gradient in smoking apparent in non-immigrants. Identification of factors that protect immigrants from manifesting marked social inequalities in smoking could inform the development of smoking preventive intervention sensitive to social inequalities in smoking. Key messages A social gradient in smoking apparent in Canada-born young adults was not observed in same-age immigrants. Factors that protect immigrants against social inequalities in smoking should be identified.

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Impact of Race and Socioeconomics Disparities on Survival in Young-Onset Colorectal Adenocarcinoma—A SEER Registry Analysis

Cancers ◽

10.3390/cancers13133262 ◽

2021 ◽

Vol 13 (13) ◽

pp. 3262

Author(s):

Mark M. Aloysius ◽

Hemant Goyal ◽

Niraj J. Shah ◽

Kumar Pallav ◽

Nimy John ◽

...

Keyword(s):

High School ◽

Marital Status ◽

Colorectal Adenocarcinoma ◽

Private Insurance ◽

School Education ◽

Cox Proportional Hazards Model ◽

High School Education ◽

Cancer Specific Survival ◽

Young Onset ◽

The Impact

Introduction: We aimed to assess the impact of socio-economic determinants of health (SEDH) on survival disparities within and between the ethnic groups of young-onset (<50 years age) colorectal adenocarcinoma patients. Patients and Methods: Surveillance, epidemiology, and end results (SEER) registry was used to identify colorectal adenocarcinoma patients aged between 25–49 years from 2012 and 2016. Survival analysis was performed using the Kaplan–Meir method. Cox proportional hazards model was used to determine the hazard effect of SEDH. American community survey (ACS) data 2012–2016 were used to analyze the impact of high school education, immigration status, poverty, household income, employment, marital status, and insurance type. Results: A total of 17,145 young-onset colorectal adenocarcinoma patients were studied. Hispanic (H) = 2874, Non-Hispanic American Indian/Alaskan Native (NHAIAN) = 164, Non-Hispanic Asian Pacific Islander (NHAPI) = 1676, Non-Hispanic black (NHB) = 2305, Non-Hispanic white (NHW) = 10,126. Overall cancer-specific survival was, at 5 years, 69 m. NHB (65.58 m) and NHAIAN (65.67 m) experienced worse survival compared with NHW (70.11 m), NHAPI (68.7), and H (68.31). High school education conferred improved cancer-specific survival significantly with NHAPI, NHB, and NHW but not with H and NHAIAN. Poverty lowered and high school education improved cancer-specific survival (CSS) in NHB, NHW, and NHAPI. Unemployment was associated with lowered CSS in H and NAPI. Lower income below the median negatively impacted survival among H, NHAPI NHB, and NHW. Recent immigration within the last 12 months lowered CSS survival in NHW. Commercial health insurance compared with government insurance conferred improved CSS in all groups. Conclusions: Survival disparities were found among all races with young-onset colorectal adenocarcinoma. The pattern of SEDH influencing survival was unique to each race. Overall higher income levels, high school education, private insurance, and marital status appeared to be independent factors conferring favorable survival found on multivariate analysis.

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