scholarly journals Social Determinants of Suboptimal Cardiovascular Health Among Pregnant Women in the United States

2022 ◽  
Author(s):  
Garima Sharma ◽  
Gowtham R. Grandhi ◽  
Isaac Acquah ◽  
Reed Mszar ◽  
Shiwani Mahajan ◽  
...  
Keyword(s):  
Physical Activity ◽  
United States ◽  
Risk Factors ◽  
Pregnant Women ◽  
Social Determinants ◽  
Cardiovascular Health ◽  
The United States ◽  
Cross Sectional ◽  
Food Education ◽  
Insufficient Physical Activity

Background Suboptimal cardiovascular health (CVH) and social determinants of health (SDOH) have a significant impact on maternal morbidity and mortality. We aimed to evaluate the association of SDOH with suboptimal CVH among pregnant women in the United States. Methods and Results We examined cross‐sectional data of pregnant women aged 18 to 49 years from the National Health Interview Survey (2013–2017). We ascertained optimal and suboptimal CVH based on the presence of 0 to 1 and ≥2 risk factors (hypertension, diabetes, hyperlipidemia, current smoking, obesity, and insufficient physical activity), respectively. We calculated an aggregate SDOH score representing 38 variables from 6 domains (economic stability; neighborhood, physical environment, and social cohesion; community and social context; food; education; and healthcare system) and divided into quartiles. We used Poisson regression model to evaluate the association of SDOH with suboptimal CVH and risk factors. Our study included 1433 pregnant women (28.8±5.5 years, 13% non‐Hispanic Black). Overall, 38.4% (95% CI, 33.9–43.0) had suboptimal CVH versus 51.7% (95% CI, 47.0–56.3) among those in the fourth SDOH quartile. Risk ratios of suboptimal CVH, smoking, obesity, and insufficient physical activity were 2.05 (95% CI, 1.46–2.88), 8.37 (95% CI, 3.00–23.43), 1.54 (95% CI, 1.17–2.03), and 1.19 (95% CI, 1.01–1.42), respectively among those in the fourth SDOH quartile compared with the first quartile. Conclusions Over 50% of pregnant women with the highest SDOH burden had suboptimal CVH, highlighting the public health urgency for interventions in socially disadvantaged pregnant women with renewed strategies toward improving modifiable risk factors, especially smoking and insufficient physical activity.

Abstract 15274: Social Determinants of Suboptimal Cardiovascular Health Among Pregnant Women in United States

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Garima Sharma ◽  
Gowtham R Grandhi ◽  
Isaac Acquah ◽  
Reed Mszar ◽  
Laxmi S Mehta ◽  
...  
Keyword(s):  
United States ◽  
Pregnant Women ◽  
Risk Score ◽  
Social Determinants ◽  
Cardiovascular Health ◽  
The United States ◽  
Cumulative Number ◽  
Cross Sectional ◽  
High Risk Women ◽  
Nationally Representative

Introduction: Cardiovascular health (CVH) and social determinants of health (SDOH) have a significant impact on maternal morbidity and mortality. We assessed the association and cumulative effects of SDOH on CVH among a nationally representative sample of pregnant women in the United States. Methods: We included cross-sectional data of pregnant women aged 18 to 49 years from the National Health Interview Survey (2013-2017). We ascertained CVH based on the following CV risk factors: hypertension, diabetes mellitus, dyslipidemia, smoking, obesity, and physical activity; classifying participants into optimal (0-1) and suboptimal (≥2) CVH. For each individual, SDOH risk score was calculated that represents the cumulative number of distinct variables (present vs absent) identified on 39 sub-components for 6 domains (economic stability, neighborhood and physical environment, community and social context, food, education, and healthcare system access). SDOH risk score was aggregated and divided into 4 quartiles. Results: Among 1,433 (3.3%, representing 2.2 million) pregnant women in US, one third (33%) of pregnant women (mean age: 33 years, 13% non-Hispanic black) had suboptimal CVH. The prevalence of hypertension, smoking, obesity and physical inactivity across the increasing SDOH quartiles were noted. Overall, 52% pregnant women with unfavorable (4 th quartile) vs 27% with favorable (1 st quartile) SDOH had suboptimal CVH. In multivariable analyses, accounting for demographics and co-morbid conditions, pregnant women with unfavorable SDOH in 4 th quartile had nearly 3-fold higher odds of suboptimal CVH. (Figure). Conclusions: Aggregate SDOH risk score provides significant discrimination of CVH in pregnant women. In pregnant women, suboptimal CVH is common and more than 1 in 2 women with highest risk of SDOH inequities have suboptimal CVH, highlighting the public health urgency for intervention in young high risk women.

Abstract P559: National Burden & Cardiovascular Risk Factor Profile of Stroke Among Young Adults in The United States

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Javier Valero Elizondo ◽  
Rohan Khera ◽  
Farhaan S Vahidy ◽  
Prachi Dubey ◽  
Haider Warraich ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Young Adults ◽  
Cardiovascular Health ◽  
Population Level ◽  
The United States ◽  
Cvd Risk ◽  
Representative Study ◽  
Insufficient Physical Activity ◽  
History Of

Introduction: Stroke is a leading cause of death and disability worldwide. While most prevalent in elderly, it’s not uncommon in the non-elderly (<65), who also experience many more years of living with disability. In this study, we aimed to describe the scope and CVD determinants of stroke among young (18-44 years) adults in a US representative population. Methods: We analyzed the National Health Interview Survey (2012-2018), a nationally representative study sample. Stroke, as well as CVD risk factors (CRF) [diabetes, hypertension, ever-smoker, insufficient physical activity, obesity and high cholesterol] were self-reported. A CRF profile was then created, with the following categories: “Optimal”, “Average” and “Poor” (0-1, 2-3 & ≥ 4 CRFs, respectively). All analyses took into consideration the survey’s complex design. Results: The 2012-2018 survey population consisted of 224,638 adults ≥ 18 yrs, ≈ 242 million US adults annually. Overall 2.8% (≈ 7 million) reported ever having history of stroke, with 45% noted in the non-elderly (< 65). Among non-elderly, 21% of stroke-history was allocated among the young (18-44 years) adults, translating to nearly 642,810 individuals reporting ever having history of stroke per year. The most common risk factors noted in these patients were insufficient physical activity (56%), current/past smoking (48%), obesity (45%), and hypertension (44%). Overall among the young (<45 years), stroke prevalence was 10-fold higher among those with poor (≈ 3.9 million young adults) vs optimal CRF profile (3.5% vs 0.3%, p < 0.001). Adjusting for demographics, all CVD risk were significantly associated with history of stroke, with participants with poor CRF reporting a 7-fold higher history of stroke (Table). Conclusion: More than half a million adults 18-44 years of age reported a history stroke in US. Individuals with sub-optimal CRF profiles are highly susceptible, and population-level strategies emphasizing cardiovascular health may significantly reduce risk of stroke among young adults in US.

scholarly journals National Trends and Reported Risk Factors Among Pregnant Women With Syphilis in the United States, 2012–2016

2019 ◽  
Vol 133 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Shivika Trivedi ◽  
Charnetta Williams ◽  
Elizabeth Torrone ◽  
Sarah Kidd
Keyword(s):  
United States ◽  
Risk Factors ◽  
Pregnant Women ◽  
The United States ◽  
National Trends

scholarly journals The Impact of Retirement on Cardiovascular Disease and Its Risk Factors: A Systematic Review of Longitudinal Studies

2019 ◽  
Vol 60 (5) ◽  
pp. e367-e377 ◽  
Author(s):  
Baowen Xue ◽  
Jenny Head ◽  
Anne McMunn
Keyword(s):  
Physical Activity ◽  
United States ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Longitudinal Studies ◽  
Leisure Time Physical Activity ◽  
The United States ◽  
European Countries ◽  
Blood Biomarkers ◽  
The Impact

Abstract Background and Objectives People are now spending longer in retirement than ever before and retirement has been found to influence health. This study systematically reviewed the impact of retirement on cardiovascular disease (CVD) and its risk factors (metabolic risk factors, blood biomarkers, physical activity, smoking, drinking, and diet). Research Design and Methods Longitudinal studies published in Medline, Embase, Social Science Citation Index, PsycINFO, and Social Policy and Practice were searched. No language restrictions were applied if there was an English abstract. Eighty-two longitudinal studies were included after critical appraisals. Results Studies in the United States often found no significant effect of retirement on CVD, while studies in European countries, except France, showed a detrimental effect of retirement on CVD. Results from the United States and several European countries consistently show that retirement increase adiposity measures among those retired from physically demanding jobs. For diabetes and hypertension, five out of nine studies suggest no effect of retirement. Retirement has been repeatedly linked to increasing leisure-time physical activity but may reduce work- and transport-related physical activity in turn. Most studies showed that retirement either decreased smoking or had no effect on smoking. The evidence did not show a clear conclusion on drinking. Only a few studies have assessed the impact on diet and blood biomarkers. Discussion and Implications Effect of retirement varies according to the health outcomes studied and country of the study population. Policy concerning extending the retirement age needs to focus on ensuring they are suited to the individual.

scholarly journals The association between informal caregiving and behavioral risk factors: a cross-sectional study

2020 ◽  
Vol 65 (6) ◽  
pp. 911-921 ◽  
Author(s):  
Sophie Gottschalk ◽  
Hans-Helmut König ◽  
Christian Brettschneider
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Smoking Behavior ◽  
Care Recipient ◽  
Behavioral Risk Factors ◽  
Behavioral Risk ◽  
Dementia Caregivers ◽  
Related Factors ◽  
Cross Sectional ◽  
Insufficient Physical Activity

Abstract Objectives This study aimed to compare informal caregivers/dementia caregivers to non-caregivers regarding alcohol consumption, smoking behavior, obesity, and insufficient physical activity and to identify caregiving-related factors (caregiving intensity, length of caregiving, relationship to the care recipient, and type of caregiving task) which are associated with behavioral risk factors in caregivers/dementia caregivers. Methods Using cross-sectional data from the Behavioral Risk Factor Surveillance System, we performed the statistical analyses applying logistic regression models and accounted for confounding using the entropy balancing approach. Results For caregivers (n = 12,044), the odds of overweight/obesity and smoking were higher (OR = 1.14/1.34, p < 0.05) and the odds of binge drinking and insufficient physical activity were lower (OR = 0.86/0.83, p < 0.05) than for non-caregivers (n = 45,925). For dementia caregivers, results point in the same direction. Caregiving-related variables tend to influence the likelihood of behavioral risk factors, but depending on the kind of factor considered, in different directions. Conclusions Being a caregiver is associated with risky and health-promoting behavior. However, the effects are relatively low. Future studies should study potential pathways between caregiving characteristics, psychological impacts of caregiving, health behavior, and mental or physical health.

Trends in Health-Related Behavioral Risk Factors Among Pregnant Women in the United States: 2001–2009

2012 ◽  
Vol 21 (3) ◽  
pp. 255-263 ◽  
Author(s):  
Guixiang Zhao ◽  
Earl S. Ford ◽  
James Tsai ◽  
Chaoyang Li ◽  
Indu B. Ahluwalia ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Pregnant Women ◽  
The United States ◽  
Behavioral Risk Factors ◽  
Behavioral Risk ◽  
Health Related

Arthritis-Related Limitations Predict Insufficient Physical Activity in Adults With Prediabetes Identified in the NHANES 2011-2014

2017 ◽  
Vol 43 (2) ◽  
pp. 163-170 ◽  
Author(s):  
Shiela M. Strauss ◽  
Margaret McCarthy
Keyword(s):  
Physical Activity ◽  
United States ◽  
Vigorous Physical Activity ◽  
Functional Limitations ◽  
Exercise Program ◽  
The United States ◽  
Health And Nutrition ◽  
Lower Education Level ◽  
Insufficient Physical Activity ◽  
Diabetes Educators

Purpose The purpose of the study was to determine the extent to which arthritis-related limitations are salient in predicting less than the recommended amount of time for adults with prediabetes to spend on moderate or vigorous physical activity. Methods Data from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) in the United States were used to identify the predictors of insufficient physical activity in a large sample of adults with prediabetes 20 years of age and older (n = 2536). Results When extrapolated to more than 45 million adults in the United States at least 20 years of age with prediabetes, 42.7% had insufficient physical activity. Having arthritis-related functional limitations was a significant predictor of insufficient physical activity, even after accounting for the statistically significant contributions of female sex, older age, lower education level, higher body mass index, and depression. Conclusion When educating and counseling adults with prediabetes, diabetes educators should assess for arthritis-related functional limitations when examining factors that may affect prediabetes progression. Recommendations for physical activity for those with mobility and other limitations need to be individualized within a tailored exercise program to accommodate their specific limitations.

scholarly journals Association of Social Networks and Physical Activity in South Asians: The Mediators of Atherosclerosis in South Asians Living in America Cohort Study

2020 ◽  
Vol 17 (2) ◽  
pp. 149-155 ◽  
Author(s):  
Mitali S. Thanawala ◽  
Juned Siddique ◽  
John A. Schneider ◽  
Alka M. Kanaya ◽  
Andrew J. Cooper ◽  
...  
Keyword(s):  
Physical Activity ◽  
United States ◽  
Social Networks ◽  
Confidence Interval ◽  
Leisure Time Physical Activity ◽  
South Asians ◽  
Ethnic Disparities ◽  
The United States ◽  
Activity Levels ◽  
Cross Sectional

Background: Eliminating racial/ethnic disparities in physical activity remains a challenge in the United States. South Asian immigrants in the United States have particularly low physical activity levels, and evidence suggests that social context may be important. This study examined associations between personal social networks and moderate to vigorous leisure-time physical activity (MVPA) among South Asians in the United States. Methods: We used cross-sectional data (2014–2017) from 689 South Asians (aged 43–85 y) who participated in the Mediators of Atherosclerosis in South Asians Living in America study. Self-reported physical activity and egocentric network data were collected from participants about their network members. Regression models were used to determine associations between social network characteristics and participants’ MVPA. Results: Participants were on average 59 years old (SD = 9) and reported 1335 metabolic equivalent minutes per week of MVPA (interquartile range = 735, 2212). Having network members who exercised or who were exercise partners associated with increased MVPA in men (β coefficient = 241 MET min/wk [95% confidence interval, 63 to 419] and β = 520 MET min/wk [95% confidence interval, 322 to 718], respectively). For women, the association was only significant if the exercise partner was a spouse. Conclusion: Physical activity interventions utilizing network members as exercise partners may have potential in South Asians but must consider gender differences.

scholarly journals Exploring the Association Between Electronic Wearable Device Use and Levels of Physical Activity Among Individuals With Depression and Anxiety: A Population Level Study

2021 ◽  
Vol 3 ◽  
Author(s):  
Henry Onyeaka ◽  
Joe Firth ◽  
Valentine Enemuo ◽  
Chioma Muoghalu ◽  
John Naslund ◽  
...  
Keyword(s):  
Physical Activity ◽  
United States ◽  
Large Scale ◽  
Population Level ◽  
The United States ◽  
Individual Characteristics ◽  
Activity Levels ◽  
Depression And Anxiety ◽  
Related Factors ◽  
Cross Sectional

Aim: The present study aimed to investigate the cross-sectional association between self-reported use of electronic wearable devices (EWDs) and the levels of physical activity among a representative sample of adults with depression and anxiety in the United States.Methods: For this cross-sectional study, data were pooled from the Health Information National Trends Survey 2019. A sample of 1,139 adults with self-reported depression and anxiety (60.9% women; mean age of 52.5 years) was analyzed. The levels of physical activity and prevalence of EWD utilization were self-reported. The chi-square tests were used to compare individual characteristics through the use of EWDs. Multivariable logistic regression was employed to investigate the association between EWDs and physical activity levels while adjusting for sociodemographic and health-related factors.Results: From the 1,139 adults with self-reported depression and anxiety, 261 (weighted percentage 28.1%) endorsed using EWD in the last year. After adjusting for covariates, the use of EWDs was only significantly associated with a higher odds of reporting intention to lose weight (OR 2.12; 95% CI 1.04, 4.35; p = 0.04). We found no association between the use of EWDs and meeting the national weekly recommendation for physical activity or resistance/strength exercise training.Conclusion: About three in 10 adults suffering from depression and anxiety in the United States reported using EWDs in the last year. The current study findings indicate that among people living with mental illness, EWD use is associated with higher odds of weight loss intent suggesting that EWDs may serve as an opening for the clinical interactions around physical health through identifying patients primed for behavior change. Further large-scale studies using randomized trial designs are needed to examine the causal relationships between EWDs and the physical activity of people with mental health conditions.

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