Association of Socioeconomic Status With Ideal Cardiovascular Health in Black Men.
Association of Socioeconomic Status With Ideal Cardiovascular Health in Black Men.
复制标题
社会经济地位与黑人男性理想心血管健康的关系
DOI：
10.1161/jaha.120.020184
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发表时间：
2021-12-07
影响因子：
5.4
通讯作者：
Joseph, Joshua J.
中科院分区：
文献类型：
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作者：
Azap, Rosevine A.;Nolan, Timiya S.;Gray, Darrell M., II;Lawson, Kiwan;Gregory, John;Capers, Quinn;Odei, James B.;Joseph, Joshua J.
黑人男性的心血管风险很高，全因死亡率是全美最高的。在大多数人群中，社会经济地位(SES)与心血管危险因素的改善有关，但在黑人男性中缺乏数据。我们研究了包括教育程度、年收入、就业状况和健康保险状况在内的SES指标与理想的心血管健康(ICH)评分的相关性，其中包括血压、血糖、胆固醇、体重指数、体育活动和非裔美国男性健康步行者中的吸烟。脑出血的6项指标被分为3级ICH评分0~2、3~4和5~6。采用多项Logistic回归模型检验SES评分与ICH评分之间的关系。在1444名男性中，7%的人达到了5至6项ICH指标。与≥的75000美元相比，年收入20000美元的患者获得3到4个脑血管疾病的几率比0到2个脑血管疾病患者低56%(P=0.016)。与私人保险(均P<；0.05)相比，与私人保险相比，医疗保险和无保险分别比私人保险低39%和35%的ICH组成部分3到4个和0到2个。教育和就业状况与黑人男性获得更高的非物质文化遗产无关。在社区居住的黑人男性中，更高的社会经济地位衡量标准显示出与更高的非物质文化遗产成就之间的复杂联系。较高的教育程度和就业状况与非物质文化遗产缺乏联系，这表明，为了解决影响黑人男性的长期健康不平等问题，提高心血管健康水平的战略可能需要解决社会经济状况以外的其他因素。
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. 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. 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.