Abstract 17213: Myocardial Infarction and Stroke Awareness Among US and Foreign-Born Adults in the 2014 and 2017 National Health Interview Survey

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ivy Mannoh ◽  
Ruth Alma N Turkson Ocran ◽  
Yvonne Commodore-mensah
Keyword(s):  
Myocardial Infarction ◽  
National Health ◽  
Indian Subcontinent ◽  
The United States ◽  
Atherosclerotic Cardiovascular Disease ◽  
Foreign Born ◽  
Cross Sectional ◽  
Stroke Symptom ◽  
Health Interview ◽  
Symptom Awareness

Background: Atherosclerotic cardiovascular disease, defined as nonfatal myocardial infarction (MI), coronary heart disease death, or fatal or nonfatal stroke, is the leading cause of death in the United States (US). MI and stroke symptom awareness reduces delays in hospitalization and mortality. We hypothesized that foreign-born persons will have lower stroke and MI symptom awareness than US-born persons. Methods: We analyzed cross-sectional data from the 2014 and 2017 National Health Interview Surveys (NHIS) on US-born and foreign-born adults from 9 regions of birth (Europe, South America, Mexico/Central America/Caribbean, Russia, Africa, Middle East, Indian subcontinent, Asia, and Southeast Asia). Our outcomes were stroke and MI symptom awareness, and the best action to take during a stroke or MI event. Awareness was defined as knowing all 5 symptoms of MI or stroke respectively, and choosing “call 911” as the best action to take in the event of an MI or stroke. Generalized linear models with Poisson distribution and a logarithmic link was used to assess disparities in awareness between foreign-born and US-born persons. We compared responses from 2014 and 2017 to assess improvement in awareness. Results: We included 63,439 participants, with mean age 38.2 years; 51% were female and 50% had less than high school education. After adjusting for age, sex, and education, we observed significant variation in MI and stroke symptom awareness and best action to take by region of birth [Table]. In comparison to US-born, foreign-born persons were less aware of MI and stroke symptoms and the best action to take. Improvement in awareness was not significant in all groups between 2014 and 2017. Conclusion: These findings suggest a disparity in MI and stroke symptom awareness among immigrants in the US. Culturally tailored public health education and health literacy initiatives are needed to help reduce these disparities in awareness.

scholarly journals Disparities in Awareness of Myocardial Infarction and Stroke Symptoms and Response Among United States– and Foreign‐Born Adults in the National Health Interview Survey

2021 ◽  
Author(s):  
Ivy Mannoh ◽  
Ruth‐Alma Turkson‐Ocran ◽  
Jasmine Mensah ◽  
Danielle Mensah ◽  
Stella S. Yi ◽  
...  
Keyword(s):  
United States ◽  
Myocardial Infarction ◽  
National Health ◽  
Indian Subcontinent ◽  
The United States ◽  
Foreign Born ◽  
Stroke Symptom ◽  
Health Interview ◽  
Symptom Awareness ◽  
Stroke Knowledge

Background Atherosclerotic cardiovascular disease, defined as nonfatal myocardial infarction (MI), coronary heart disease death, or fatal or nonfatal stroke, is the leading cause of death in the United States. MI and stroke symptom awareness and response reduce delays in hospitalization and mortality. Methods and Results We analyzed cross‐sectional data from the 2014 and 2017 National Health Interview Surveys on US‐ and foreign‐born adults from 9 regions of birth (Europe, South America, Mexico/Central America/Caribbean, Russia, Africa, Middle East, Indian subcontinent, Asia, and Southeast Asia). The outcomes were recommended MI and stroke knowledge, defined as knowing all 5 symptoms of MI or stroke, respectively, and choosing “call 9‐1‐1” as the best response. We included 63 059 participants, with a mean age 49.4 years; 54.1% were women, and 38.5% had a high school education or less. Recommended MI and stroke knowledge were highest in US‐born people. In both 2014 and 2017, MI knowledge was lowest in individuals born in Asia (23.9%±2.5% and 32.1%±3.3%, respectively), and stroke knowledge lowest for the Indian subcontinent (44.4%±2.4% and 46.0%±3.2%, respectively). Among foreign‐born adults, people from Russia and Europe had the highest prevalence of recommended MI knowledge in 2014 (37.4%±5.4%) and 2017 (43.5%±2.5%), respectively, and recommended stroke knowledge was highest in people from Europe (61.0%±2.6% and 67.2%±2.5%). Improvement in knowledge was not significant in all groups between 2014 and 2017. Conclusions These findings suggest a disparity in MI and stroke symptom awareness and response among immigrants in the United States. Culturally tailored public health education and health literacy initiatives are needed to help reduce these disparities in awareness.

scholarly journals Is e-cigarette use associated with coronary heart disease and myocardial infarction? Insights from the 2016 and 2017 National Health Interview Surveys

2019 ◽  
Vol 10 ◽  
pp. 204062231987774 ◽  
Author(s):  
Konstantinos E Farsalinos ◽  
Riccardo Polosa ◽  
Fabio Cibella ◽  
Raymond Niaura
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
National Health ◽  
Pooled Analysis ◽  
Cigarette Use ◽  
Cross Sectional ◽  
Health Interview ◽  
Cross Sectional Design

Background: This study analyzed the National Health Interview Surveys (NHIS) of 2016 ( n = 33,028) and 2017 ( n = 26,742) to examine whether e-cigarette use is consistently associated with myocardial infarction (MI) and coronary heart disease (CHD). Methods: Surveys were examined separately and pooled. Logistic regression analysis was used, with demographics, e-cigarette use, smoking and risk factors for CHD (hypertension, hypercholesterolemia, and diabetes) being independent variables. Former smokers were subclassified according to quit duration (⩽ 6 and > 6 years). Results: For MI, an association was observed with some days e-cigarette (but not daily) use in the 2017 survey (OR: 2.11, 95% CI: 1.14–3.88, p = 0.017). No statistically significant association was observed in the pooled analysis (daily e-cigarette use: OR: 1.35, 95% CI: 0.80–2.27, p = 0.267). For CHD, an association was observed with daily e-cigarette use in the 2016 survey (OR: 1.89, 95% CI: 1.01–3.53, p = 0.047). From the pooled analysis, no association was found between any pattern of e-cigarette use and CHD. In single-year and pooled analysis, both MI and CHD were strongly associated with all patterns of smoking, hypertension, hypercholesterolemia, diabetes, and age. Conclusions: The pooled analysis of the 2016 and 2017 NHIS showed no association between e-cigarette use and MI or CHD. The associations between established risk factors, including smoking, and both conditions were remarkably consistent. The inconsistent associations observed in single-year surveys and the cross-sectional design of the NHIS cannot substantiate any link between e-cigarette use and an elevated risk for MI or CHD. Longitudinal studies are needed to explore the effects of e-cigarette use on cardiovascular disease.

scholarly journals Minorities’ Diminished Returns of Educational Attainment on Hospitalization Risk: National Health Interview Survey (NHIS)

2019 ◽  
Vol 4 (3) ◽  
pp. 86-91 ◽  
Author(s):  
Shervin Assari ◽  
Mohsen Bazargan
Keyword(s):  
Educational Attainment ◽  
National Health ◽  
National Health Interview Survey ◽  
Total Sample ◽  
The United States ◽  
Protective Effects ◽  
Cross Sectional ◽  
Health Interview Survey ◽  
Health Interview ◽  
Interview Survey

Background: As suggested by the Minorities’ Diminished Returns (MDRs) theory, educational attainment shows a weaker protective effect for racial and ethnic minority groups compared to non-Hispanic Whites. This pattern, however, is never shown for hospitalization risk. Objectives: This cross-sectional study explored racial and ethnic variations in the association between educational attainment and hospitalization in the United States. Methods: Data came from the National Health Interview Survey (NHIS 2015). The total sample was 28,959 American adults. Independent variable was educational attainment. The main outcome was hospitalization during the last 12 months. Age, gender, employment, marital status, region, obesity, and number of cardiovascular conditions were covariates. Race and ethnicity were the effect modifiers. Logistic regression models were utilized to analyze the data. Results: From all participants, 16.2% were Black and 11.6% were Hispanic with a mean age of 51 years. Overall, higher education levels were associated with lower odds of hospitalization, independent of all confounders. Educational attainment showed significant interactions with race (odds ratio [OR] =1.04, 95% CI = 1.01-1.08) and ethnicity (OR = 1.04, 95% CI =1.01-1.07) on hospitalization, indicating smaller protective effects of educational attainment on hospitalization of Hispanics and Blacks than nonHispanic Whites. Conclusion: The protective effects of educational attainment on population health are smaller for Blacks and Hispanics compared to non-Hispanic Whites. To prevent health disparities, the diminished returns of educational attainment should be minimized for racial and ethnic minorities. To do so, there is a need for innovative and bold economic, public, and social policies that do not limit themselves to equalizing socioeconomic status, but also help minorities leverage their available resources and gain tangible outcomes.

scholarly journals Association Between Sociodemographic Determinants and Disparities in Stroke Symptom Awareness Among US Young Adults

Stroke ◽  
2020 ◽  
Vol 51 (12) ◽  
pp. 3552-3561 ◽  
Author(s):  
Reed Mszar ◽  
Shiwani Mahajan ◽  
Javier Valero-Elizondo ◽  
Tamer Yahya ◽  
Richa Sharma ◽  
...  
Keyword(s):  
United States ◽  
Young Adults ◽  
National Health ◽  
Odds Ratio ◽  
National Health Interview Survey ◽  
The United States ◽  
Health Interview Survey ◽  
Health Interview ◽  
Symptom Awareness ◽  
Interview Survey

Background and Purpose: Despite declining stroke rates in the general population, stroke incidence and hospitalizations are rising among younger individuals. Awareness of and prompt response to stroke symptoms are crucial components of a timely diagnosis and disease management. We assessed awareness of stroke symptoms and response to a perceived stroke among young adults in the United States. Methods: Using data from the 2017 National Health Interview Survey, we assessed awareness of 5 common stroke symptoms and the knowledge of planned response (ie, calling emergency medical services) among young adults (<45 years) across diverse sociodemographic groups. Common stroke symptoms included: (1) numbness of face/arm/leg, (2) confusion/trouble speaking, (3) difficulty walking/dizziness/loss of balance, (4) trouble seeing in one/both eyes, and (5) severe headache. Results: Our study population included 24 769 adults, of which 9844 (39.7%) were young adults who were included in our primary analysis, and represented 107.2 million US young adults (mean age 31.3 [±7.5] years, 50.6% women, and 62.2% non-Hispanic White). Overall, 2718 young adults (28.9%) were not aware of all 5 stroke symptoms, whereas 242 individuals (2.7%; representing 2.9 million young adults in the United States) were not aware of a single symptom. After adjusting for confounders, Hispanic ethnicity (odds ratio, 1.96 [95% CI, 1.17–3.28]), non-US born immigration status (odds ratio, 2.02 [95% CI, 1.31–3.11]), and lower education level (odds ratio, 2.77 [95% CI, 1.76–4.35]), were significantly associated with lack of symptom awareness. Individuals with 5 high-risk characteristics (non-White, non-US born, low income, uninsured, and high school educated or lower) had nearly a 4-fold higher odds of not being aware of all symptoms (odds ratio, 3.70 [95% CI, 2.43–5.62]). Conclusions: Based on data from the National Health Interview Survey, a large proportion of young adults may not be aware of stroke symptoms. Certain sociodemographic subgroups with decreased awareness may benefit from focused public health interventions.

Abstract 123: A Comparison of In-Hospital Acute Myocardial Infarction Management Between Portugal and the United States: 2000 - 2010

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Mariana F Lobo ◽  
Vanessa Azzone ◽  
Luis Azevedo ◽  
Armando Teixeira-Pinto ◽  
Jose Pereira Miguel ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
The United States ◽  
Billing Data ◽  
Cross Sectional ◽  
Medical Technologies ◽  
Hospitalization Rates ◽  
The Us ◽  
International Comparative

Objectives: Because inter- and intra-country variations in the adoption of medical technologies exist, international comparative studies provide an opportunity to infer technology effectiveness. Few studies have characterized recent trends in acute myocardial infarction (AMI) management between countries. Methods: Repeated cross-sectional observational cohorts of hospitalized adults aged ≥20 years discharged between January 2000 and December 2010. We identified new AMI hospitalizations using a US national 20% inpatient sample and a 100% inpatient sample in all Portuguese public sector hospitals. Age, sex, comorbidities, and median length of stay (interquartile range [IQR]) were determined. Annual age-sex adjusted hospitalization rates (HR) for AMI, in-hospital procedures, and in-hospital mortality were directly standardized to the 2010 US population. Intra-country (2010 relative to 2000) and inter-country in 2010 (Portugal [PT] relative to US) rate ratios [RR] were estimated. Findings: We identified 1476808 AMI US hospitalizations and 126314 Portugal hospitalizations between 2000 and 2010. Portuguese patients were more male, younger, and had fewer comorbidities compared to US patients (Table). The age-sex adjusted AMI HR decreased from 21 per 1000 person-years to 15 in the US (RR=0.70; 95% CI = [0.70, 0.71]) but increased in PT (14 to 15 per 1000, RR = 1.17 [1.14, 1.21]). While crude procedure rates were uniformly lower in PT, only CABG rates differed after standardization (2010: RR=0.19 [0.14, 0.26]). PCI use increased annually in both countries and decreased for CABG in the US only (102 to 79, RR=0.77 [0.73, 0.81]). Standardized in-hospital mortality decreased within-country (US: 44 to 29 per 1000, RR= 0.65 [0.60, 0.72]; PT: 93 to 62 per 1000, RR= 0.67 [0.44, 1.00]). In 2010, PT mortality was twice that in the US. Conclusions: AMI hospitalization rates and use of medical technologies are higher in the US compared to Portugal. However, standardized rates reveal only CABG surgery rates differ significantly between the two countries. Outcomes, measured by hospital mortality and LOS, are generally better in the U.S. Inter-country disparities may be a consequence of differential use of technologies, differences in AMI epidemiology, patient risk, or quality of hospital billing data.

scholarly journals Changes among US Cancer Survivors: Comparing Demographic, Diagnostic, and Health Care Findings from the 1992 and 2010 National Health Interview Surveys

ISRN Oncology ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Natasha D. Buchanan ◽  
Jessica B. King ◽  
Juan L. Rodriguez ◽  
Arica White ◽  
Katrina F. Trivers ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Support Groups ◽  
National Health ◽  
Clinical Care ◽  
Quality Care ◽  
Insurance Coverage ◽  
Cancer Control ◽  
The United States ◽  
Institute Of Medicine ◽  
Health Interview

Background. Differences in healthcare and cancer treatment for cancer survivors in the United States (US) have not been routinely examined in nationally representative samples or studied before and after important Institute of Medicine (IOM) recommendations calling for higher quality care provision and attention to comprehensive cancer care for cancer survivors. Methods. To assess differences between survivor characteristics in 1992 and 2010, we conducted descriptive analyses of 1992 and 2010 National Health Interview Survey (NHIS) data. Our study sample consisted of 1018 self-reported cancer survivors from the 1992 NHIS and 1718 self-reported cancer survivors from the 2010 NHIS who completed the Cancer Control (CCS) and Cancer Epidemiology (CES) Supplements. Results. The prevalence of reported survivors increased from 1992 to 2010 (4.2% versus 6.3%). From 1992 to 2010, there was an increase in long-term cancer survivors and a drop in multiple malignancies, and surgery remained the most widely used treatment. Significantly fewer survivors (<10 years after diagnosis) were denied insurance coverage. Survivors continue to report low participation in counseling or support groups. Conclusions. As the prevalence of cancer survivors continues to grow, monitoring differences in survivor characteristics can be useful in evaluating the effects of policy recommendations and the quality of clinical care.

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