Geographic Variations in Cardiovascular Health in the United States: Contributions of State- and Individual-Level Factors
Geographic Variations in Cardiovascular Health in the United States: Contributions of State- and Individual-Level Factors
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DOI：
10.1161/jaha.114.001673
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发表时间：
2015-06-01
影响因子：
5.4
通讯作者：
Diez-Roux, Ana V.
中科院分区：
文献类型：
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作者：
Gebreab, Samson Y.;Davis, Sharon K.;Diez-Roux, Ana V.
到2020年改善所有美国人的心血管健康（CVH）是美国心脏协会的战略目标。了解变异的来源和识别与差CVH相关的背景因素可能提示预防的重要途径。方法和结果2011年行为危险因素监测系统的横截面数据与国家生命统计系统的国家级冠心病和中风死亡率数据以及国家级家庭收入中位数，收入不平等，从各种行政来源对苏打饮料和香烟以及食品和体育活动环境征税。根据美国心脏协会的定义，使用7个自我报告的CVH指标（目前吸烟、缺乏身体活动、肥胖、饮食不良、高血压、糖尿病和高胆固醇）定义CVH不良。链接的微地图图和多层次逻辑模型被用来检查状态的变化，在穷人CVH和调查个人和国家层面的因素，这种变化的贡献。我们发现，在低CVH的患病率方面，州一级存在显著差异（中位数比值比为1.32，P
Background-Improving cardiovascular health (CVH) of all Americans by 2020 is a strategic goal of the American Heart Association. Understanding the sources of variation and identifying contextual factors associated with poor CVH may suggest important avenues for prevention.Methods and Results-Cross-sectional data from the Behavioral Risk Factor Surveillance System for the year 2011 were linked to state-level coronary heart disease and stroke mortality data from the National Vital Statistics System and to state-level measures of median household income, income inequality, taxes on soda drinks and cigarettes, and food and physical activity environments from various administrative sources. Poor CVH was defined according to the American Heart Association definition using 7 selfreported CVH metrics (current smoking, physical inactivity, obesity, poor diet, hypertension, diabetes, and high cholesterol). Linked micromap plots and multilevel logistic models were used to examine state variation in poor CVH and to investigate the contributions of individual-and state-level factors to this variation. We found significant state-level variation in the prevalence of poor CVH (median odds ratio 1.32, P