scholarly journals Association of Socioeconomic Status With Ideal Cardiovascular Health in Black Men

2021 ◽  
Author(s):  
Rosevine A. Azap ◽  
Timiya S. Nolan ◽  
Darrell M. Gray ◽  
Kiwan Lawson ◽  
John Gregory ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Cardiovascular Risk ◽  
Educational Attainment ◽  
Black Men ◽  
Employment Status ◽  
Cardiovascular Health ◽  
Annual Income ◽  
Lower Odds ◽  
Ideal Cardiovascular Health ◽  
Ich Score

Background Black men are burdened by high cardiovascular risk and the highest all‐cause mortality rate in the United States. Socioeconomic status (SES) is associated with improved cardiovascular risk factors in majority populations, but there is a paucity of data in Black men. Methods and Results We examined the association of SES measures including educational attainment, annual income, employment status, and health insurance status with an ideal cardiovascular health (ICH) score, which included blood pressure, glucose, cholesterol, body mass index, physical activity, and smoking in African American Male Wellness Walks. Six metrics of ICH were categorized into a 3‐tiered ICH score 0 to 2, 3 to 4, and 5 to 6. Multinomial logistic regression modeling was performed to examine the association of SES measures with ICH scores adjusted for age. Among 1444 men, 7% attained 5 to 6 ICH metrics. Annual income <$20 000 was associated with a 56% lower odds of attaining 3 to 4 versus 0 to 2 ICH components compared with ≥$75 000 ( P =0.016). Medicare and no insurance were associated with a 39% and 35% lower odds of 3 to 4 versus 0 to 2 ICH components, respectively, compared with private insurance (all P <0.05). Education and employment status were not associated with higher attainment of ICH in Black men. Conclusions Among community‐dwelling Black men, higher attainment of measures of SES showed mixed associations with greater attainment of ICH. The lack of association of higher levels of educational attainment and employment status with ICH suggests that in order to address the long–standing health inequities that affect Black men, strategies to increase attainment of cardiovascular health may need to address additional components beyond SES.

Abstract P084: The Association Of Socioeconomic Status With Ideal Cardiovascular Health In African American Males

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Rosevine A Azap ◽  
Timiya Nolan ◽  
Darrell Gray ◽  
Kiwan Lawson ◽  
John Gregory ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
African American ◽  
Cardiovascular Risk ◽  
African American Males ◽  
Health Care Professionals ◽  
Cardiovascular Health ◽  
The United States ◽  
Community Dwelling ◽  
Ideal Cardiovascular Health ◽  
Ich Score

Introduction: African American (AA) men are burdened by high cardiovascular risk and have the highest age-adjusted all-cause mortality rate in the United States of America (US). Socioeconomic status (SES) is associated with improved cardiovascular risk factors in majority populations, but there is a paucity of data in AA men. Hypothesis: We hypothesized that higher levels of socioeconomic status would be associated with higher attainment of ideal cardiovascular health in AA men. Methods: We examined the association of socioeconomic status measures including education, income, occupation, and insurance status with an ideal cardiovascular health (ICH) score which included blood pressure, glucose, cholesterol, body mass index (BMI), physical activity, and smoking in African American Male Wellness Walks (AAMWW). Six metrics of ICH were categorized into a three-tiered ICH score 0-2, 3-4, 5-6. Ordinal logistic regression modeling was performed with adjustment for age. Results: Among 1,444 men, 108 (7%) attained 5-6 ICH metrics at baseline. After adjustment for age, none of the baseline indicators of socioeconomic status were associated with attainment of ICH. Conclusion: In our community-dwelling sample of AA men, the proportion of individuals with highest scores for ICH was very low, and SES was not associated with greater attainment of ICH. Strategies to increase attainment of cardiovascular health in AA men by health care professionals and policymakers need to incorporate intentional interventions beyond the scope of SES in order to advance health equity in AA men.

scholarly journals Ideal Cardiovascular Health in Urban Jamaica: Prevalence Estimates and Relationship to Community Property Value, Household Assets and Educational Attainment

2020 ◽  
Author(s):  
Joette A. McKenzie ◽  
Novie O. Younger-Coleman ◽  
Marshall K. Tulloch-Reid ◽  
Ishtar Govia ◽  
Nadia R. Bennett ◽  
...  
Keyword(s):  
Educational Attainment ◽  
Cardiovascular Health ◽  
Survey Design ◽  
Moderate Physical Activity ◽  
Normal Body Mass Index ◽  
Cross Sectional ◽  
Lower Odds ◽  
Ideal Cardiovascular Health ◽  
Community Property ◽  
Household Assets

ABSTRACTBACKGROUNDIdeal cardiovascular health (ICH) is associated with greater longevity and reduced morbidity, but no research on ICH has been conducted in Jamaica. We estimated the prevalence of ICH in urban Jamaica and evaluated associations between ICH and community, household and individual socioeconomic status (SES).METHODSCross-sectional study using data from 360 men and 665 women, age ≥20 years in urban Jamaica. ICH was defined as having seven characteristics: current non-smoking, healthy diet, moderate physical activity, and normal body mass index, blood pressure, glucose, and cholesterol. Logistic regression, weighted for survey design, quantified association between the outcome (≥5 ICH characteristics [ICH-5]), and exposure variables (tertiles of community median land value [MLV], tertiles of household assets and educational attainment).RESULTSPrevalence of ICH (7 characteristics) was 0.51%, while prevalence of ICH-5 was 22.9% (male 24.5%, female 21.5%, p=0.447). In sex-specific multivariable models adjusted for age, education, and household assets, men in the lower tertiles of community MLV had lower odds of ICH-5 compared to men in the upper tertile (lowest tertile: OR 0.33, 95%CI 0.12-0.91, p=0.032; middle tertile: OR 0.46 (0.20-1.04) p=0.062). Women from communities in the lower and middle tertiles of MLV also had lower odds of ICH-5, but association was not statistically significant. Educational attainment was inversely associated with ICH-5 among men and positively associated among women. No significant association was seen for household assets.CONCLUSIONPrevalence of ICH is low in urban Jamaica. Living in poorer communities was associated with lower odds of ICH-5 among men. Higher education was associated with higher odds of ICH-5 among women but lowers odds among men.

scholarly journals Ideal cardiovascular health in urban Jamaica: prevalence estimates and relationship to community property value, household assets and educational attainment: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040664
Author(s):  
Joette A McKenzie ◽  
Novie O Younger ◽  
Marshall Kerr Tulloch-Reid ◽  
Ishtar Govia ◽  
Nadia R Bennett ◽  
...  
Keyword(s):  
Educational Attainment ◽  
Cardiovascular Health ◽  
Cross Sectional Study ◽  
Education Level ◽  
Outcome Variable ◽  
Sectional Study ◽  
Cross Sectional ◽  
Lower Odds ◽  
Ideal Cardiovascular Health ◽  
Household Assets

ObjectiveIdeal cardiovascular health (ICH) is associated with greater longevity and reduced morbidity, but no research on ICH has been conducted in Jamaica. We aimed to estimate the prevalence of ICH in urban Jamaica and to evaluate associations between ICH and community, household, and individual socioeconomic status (SES).DesignCross-sectional study.SettingUrban communities in Jamaica.Participants360 men and 665 women who were urban residents aged ≥20 years from a national survey, the Jamaica Health and Lifestyle Survey 2016–2017.ExposuresCommunity SES, using median land values (MLV); household SES, using number of household assets; and individual SES, using education level.Primary outcomeThe main outcome variable was ICH, defined as having five or more of seven ICH characteristics (ICH-5): current non-smoking, healthy diet, moderate physical activity, normal body mass index, normal blood pressure, normal glucose and normal cholesterol. Prevalence was estimated using weighted survey design and logistic regression models were used to evaluate associations.ResultsThe prevalence of overall ICH (seven characteristics) was 0.51%, while the prevalence of ICH-5 was 22.9% (male 24.5%, female 21.5%, p=0.447). In sex-specific multivariable models adjusted for age, education, and household assets, men in the lower tertiles of community MLV had lower odds of ICH-5 compared with men in the upper tertile (lowest tertile: OR 0.33, 95% CI 0.12 to 0.91, p=0.032; middle tertile: OR 0.46, 95% CI 0.20 to 1.04, p=0.062). Women from communities in the lower and middle tertiles of MLV also had lower odds of ICH-5, but the association was not statistically significant. Educational attainment was inversely associated with ICH-5 among men and positively associated among women.ConclusionLiving in poorer communities was associated with lower odds of ICH-5 among men in Jamaica. The association between education level and ICH-5 differed in men and women.

Abstract P196: Insomnia Symptoms And Ideal Cardiovascular Health In Older Women: Data From The Women’S Health Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Cameron Hicks ◽  
Jonathan Butler ◽  
Natalie B Slopen ◽  
David Williams ◽  
Dayna A Johnson ◽  
...  
Keyword(s):  
Women’S Health ◽  
Women's Health ◽  
Older Women ◽  
Sleep Duration ◽  
Cardiovascular Health ◽  
Health Study ◽  
Lower Odds ◽  
Ideal Cardiovascular Health ◽  
The Relationship ◽  
Insomnia Symptoms

Introduction: While insomnia is associated with an increased risk of incident cardiovascular disease (CVD), its relationship with ideal cardiovascular health (ICH) is less certain. Given that sleep disturbances increase with age, we examined the relationship between insomnia symptoms and ICH in older women. Methods: Among women participating in the ongoing Women’s Health Study stress cohort with no apparent history of CVD [N= 2588; Mean age= 72.5 ± 6.3], insomnia symptoms were characterized as self-reported difficulty falling asleep or waking up multiple times a night, three or more times per week. Ideal cardiovascular health, as defined by the American Heart Association’s 2020 Impact goals, included standard optimal targets for blood pressure, total cholesterol, glucose, body mass index, physical activity, diet, and smoking. We examined the relationship between insomnia symptoms and ICH using logistic regression, adjusting for clinical and demographic variables. Results: Of the 26588 participants, 52% reported insomnia symptoms, and 38% had ICH. Women with insomnia symptoms had significantly lower odds of ICH after full adjustment for age, race/ethnicity, education, income, depression/anxiety, marital status, and sleep duration (OR [95% CI]: 0.73 [0.64-0.83]). Moreover, compared to women without insomnia symptoms, those with insomnia symptoms were significantly more likely to have hypertension, diabetes, hypercholesterolemia, depression, anxiety, currently smoke, drink one or more alcoholic beverages per day, have a BMI >30, or exercise less frequently. Conclusion: In older women, insomnia symptoms were significantly associated with lower odds of ideal cardiovascular health even after adjusting for socioeconomic status, psychosocial factors, and sleep duration. These results suggest insomnia screening may be an important component of cardiovascular health promotion in this patient population. Further research is needed to evaluate the effects of sleep behavioral interventions on improving ICH.

American Heart Association ideal cardiovascular health score and subclinical atherosclerosis in 22–35-year-old adults conceived with and without assisted reproductive technologies

2019 ◽  
Vol 35 (1) ◽  
pp. 232-239 ◽  
Author(s):  
Markus Juonala ◽  
Sharon Lewis ◽  
Robert McLachlan ◽  
Karin Hammarberg ◽  
Joanne Kennedy ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
American Heart Association ◽  
Cardiovascular Health ◽  
American Heart ◽  
Subclinical Atherosclerosis ◽  
Heart Association ◽  
Categorical Variables ◽  
Inverse Association ◽  
Health Score ◽  
Ideal Cardiovascular Health

Abstract STUDY QUESTION Is ART related with the association of American Heart Association (AHA) ideal cardiovascular health score and markers of subclinical atherosclerosis? SUMMARY ANSWER The associations between AHA score and markers of subclinical atherosclerosis in ART and non-ART groups were similar in magnitude. WHAT IS KNOWN ALREADY Long-term consequences of ART on cardiovascular health are unknown. STUDY DESIGN, SIZE, DURATION The study cohort for the cross-sectional analyses consisted of 172 ART-conceived and 78 non-ART conceived individuals of same age (range 22–35 years). PARTICIPANTS/MATERIALS, SETTING, METHODS Cardiovascular risk factor status was evaluated with American Heart Association (AHA) ideal cardiovascular health score consisting of seven factors (body mass index, blood pressure, total cholesterol, glucose, diet and physical activity, non-smoking). Carotid artery intima-media thickness (cIMT), arterial pulse-wave velocity (PWV) and retinal microvascular parameters were evaluated as markers of early atherosclerosis. Group comparisons in continuous variables were performed with t-tests. For categorical variables, comparisons were performed with chi-square tests. The relationships between AHA score and the markers of atherosclerosis were examined with linear regression analyses adjusted for age and sex. MAIN RESULTS AND THE ROLE OF CHANCE There was no difference in AHA ideal health score between the ART and non-ART groups; mean (SD) scores were 4.1(1.4) versus 4.0(1.5), respectively, P = 0.65. No differences were observed between groups for any individual ideal health metric (P always &gt;0.2). AHA score was not associated with cIMT or retinal measures in either group (P always &gt;0.05). An inverse association was observed between AHA score and PWV in the ART group (beta (95% CI) −0.18(−0.26 to −0.10)). A numerically similar relationship was observed in the smaller non-ART group (−0.19(−0.39 to 0.01)). LIMITATIONS, REASONS FOR CAUTION Even though this cohort is among the largest ART studies with extensive cardiovascular data, the sample is still relatively small and the statistical power is limited. As the study population was still in early adulthood, we were not able to evaluate the associations with clinical cardiovascular events, but utilized non-invasive methods to assess early markers of subclinical atherosclerosis. WIDER IMPLICATIONS OF THE FINDINGS These findings suggest that ART-conceived individuals do not have increased vulnerability for cardiovascular risk factors. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by a National Health & Medical Research Council Project Grant (APP1099641), The Royal Children’s Hospital Research Foundation, Monash IVF Research and Education Foundation, and Reproductive Biology Unit Sperm Fund, Melbourne IVF. The authors have no conflicts of interest relevant to this article to disclose.

Evaluating the sensitivity of the ACC/AHA pooled cohort risk calculator to predict atherosclerotic cardiovascular events within 10 years: how many events are we failing to predict?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Medina-Inojosa ◽  
V.K Somers ◽  
S Hayes ◽  
R Mankad ◽  
F Lopez-Jimenez
Keyword(s):  
Cardiovascular Risk ◽  
Cardiovascular Health ◽  
Fasting Blood Glucose ◽  
Low Risk ◽  
P Value ◽  
Funding Source ◽  
Atherosclerotic Cardiovascular Disease ◽  
Ideal Cardiovascular Health ◽  
Ascvd Risk

Abstract Background The ACC/AHA Pooled Cohort Equation (PCE) for atherosclerotic cardiovascular disease (ASCVD) has been recommended as the initial step in cardiovascular risk assessment. The sensitivity of this tool to detect those who will develop ASCVD within 10-years, while considering age and sex groups, has not been extensively studied. Methods Using the Rochester Epidemiology Project (REP) we evaluated a community-based cohort of consecutive patients that sought primary care in Olmsted County, MN, between the years 1998–2000 and were followed up through March 1st 2016. Inclusion criteria were ages 40–79 and complete data to calculate the PCE. We excluded those with known ASCVD, atrial fibrillation or heart failure. Criteria were similar to those used to derive the PCE. Events were validated in duplicate and included fatal and non-fatal myocardial infarction and ischemic stroke. Patient information was ascertained using the record linkage system of the REP. Follow-up was truncated at 10 years. We assessed the ASCVD predicted risk (categorized as low &lt;5%, intermediate 5–9.9%, high 10–19.9%, and very high ≥20% risk) at baseline, in subjects having an ASCVD event within 10-years in the community across age (&lt;65 years) and sex categories. We also categorized ideal cardiovascular health as ≥4 metrics [non-smoker, body mass index &lt;25 kg/m2, and not having of elevated blood pressure (≥130/80 mmHg), LDL cholesterol (&gt;100 mg/dL), or fasting blood glucose (&gt;100 mg/dL), in the absence of a medical diagnosis or treatment]. Results We included 30,042 adults, mean ± SD age 48.5±12.2 years, 54% women, with a median follow-up of 16.5±5.3 years. There were 1,555 ASCVD events (5.2%) at 10 years of follow-up. The performance of the PCE was similar to what was described in the original report (0.78 vs 0.79). Overall, among those who suffered an ASCVD, 54% of women and 41% of men were not high risk as predicted by PCE (Figure 1A). Most women (73%) &lt;65 years of age would had been considered low risk within 10-years before the event, and only 10% would have been considered to be high risks (Figure 1B). Nonetheless, women &lt;65 years who had an ASCVD event and low 10-year predicted ASCVD risk by PCE were less likely to have ideal cardiovascular health [55 (0.40%) vs 3884 (28.39%), p-value&lt;0.0001], when compared to women in the low risk category without an event. Conclusion The PCE fails to identify most women who will develop an ASCVD event, particularly women &lt;65 years of age. These results underscore the importance of using additional information when estimating ASCVD risk among women and the need for better cardiovascular risk prediction tools. Figure 1 Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Mayo Clinic

scholarly journals Double burden of malnutrition in children aged 24-59 months by socioeconomic status in five South Asian countries: evidence from Demographic and Health Surveys

2019 ◽  
Author(s):  
Fariha Binte Hossain ◽  
Md Shajedur Rahman Shawon ◽  
Md Shehab Uddin Al-Abid ◽  
Sultan Mahmood Sami ◽  
Gourab Adhikary ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Educational Attainment ◽  
South Asian ◽  
Household Wealth ◽  
Demographic And Health Surveys ◽  
Socioeconomic Conditions ◽  
Asian Countries ◽  
Double Burden ◽  
Lower Odds ◽  
Double Burden Of Malnutrition

ABSTRACTBackgroundDeveloping countries are now facing double burden of undernutrition and overnutrition among children and adults. We aimed to explore the double burden of malnutrition among children aged 24-59 months by household’s socioeconomic status in South Asian context.MethodsChildren with valid information on height and weight from the latest Demographic and Health Survey from Bangladesh, India, Pakistan, Maldives, and Nepal were included in this study. Underweight and overweight were defined according to definitions of World Health Organisation and International Obesity Task Force, respectively. We used multiple logistic regressions to estimate the association of socioeconomic status with childhood underweight and overweight.ResultsSouth Asian countries had significant burden of underweight, ranging from 19% in Maldives to 38% in India. Bangladesh, India, and Nepal had prevalence of overweight between 2% and 4%, whereas Pakistan and Maldives had prevalence of 7% and 9%, respectively. Households with higher wealth index and education were consistently associated with lower odds of underweight children. When compared to poorest households, richest households had higher odds of being overweight in Bangladesh (OR 1.96, 95% CI 1.27-3.02) and India (OR 1.53, 95% CI 1.41-1.66) while lower odds of being overweight in Pakistan (OR 0.22, 95% CI 0.14-0.34). Households with higher education were more likely to have overweight children in Bangladesh and India.ConclusionsChildhood underweight is associated with lower socioeconomic conditions while there is a substantial burden of childhood overweight in higher socioeconomic groups. These disparities by socioeconomic conditions should be considered while developing national nutrition programs and strategies.KEY MESSAGESIn South Asia, there is a substantial burden of undernutrition among under-five children while a differential burden of overnutrition is also seen.Household wealth and educational attainment were inversely associated with childhood underweight.Children in households with higher levels of wealth and educational attainment were more likely to be overweight in Bangladesh and India, while evidence supporting such association was not clear for other South Asian countries.The urban-rural difference in the burden of childhood underweight and overweight can be explained by the distributions of households’ socioeconomic status.

scholarly journals Racial Differences in Prostate Cancer Treatment: The Role of Socioeconomic Status

2017 ◽  
Vol 27 (3) ◽  
pp. 201 ◽  
Author(s):  
Megan Watson ◽  
David Grande ◽  
Archana Radhakrishnan ◽  
Nandita Mitra ◽  
Katelyn R. Ward ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Socioeconomic Status ◽  
Black Men ◽  
Racial Differences ◽  
Employment Status ◽  
White Men ◽  
Definitive Treatment ◽  
Prostate Cancer Treatment ◽  
To Receive ◽  
Neighborhood Ses

<p><strong>Objective: </strong>This study examines whether socioeconomic status (SES), measured at both the individual and neighborhood levels, is associated with receipt of definitive treatment for localized prostate cancer and whether these associations mediate racial differences in treatment between non-Hispanic White and non-Hispanic Black men. </p><p><strong>Design: </strong>The Philadelphia Area Prostate Cancer Access Study (P2 Access) is a mailed, cross-sectional survey of men sampled from the Pennsylvania Cancer Registry, combined with neighborhood Census data. </p><p><strong>Setting: </strong>Eight counties in southeastern Pennsylvania. </p><p><strong>Participants: </strong>2,386 men with prostate adenocarcinoma. </p><p><strong>Main Measures: </strong>Receipt of definitive treatment, race, self-reported income, education, employment status, and neighborhood SES. </p><p><strong>Results: </strong>Overall, Black and White men were equally likely to receive definitive treatment. Men living in neighborhoods with higher SES were more likely to receive definitive treatment (OR 1.57, 95%CI 1.01, 2.42). Among men who received definitive treatment, Black men were significantly less likely to receive radical prostatectomy compared with White men (OR .71, 95% CI .52, .98), as were men with some college education compared with those with a high school education or less (OR .66, 95% CI .47, .94). SES does not mediate racial differences in receipt of definitive treatment or the type of definitive treatment received, and associations with income or employment status were not significant. </p><p><strong>Conclusions: </strong>These results stress the importance of examining racial disparities within geographic areas and highlight the unique associations that different measures of SES, particularly neighborhood SES and education, may have with prostate cancer treatment.</p><p><em>Ethn Dis. </em>2017;27(3):201-208; doi:10.18865/ed.27.3.201. </p>

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