Merkin Sharon Stein, Karlamangla Arun, Crimmins Eileen, Charette Susan L, Hayward Mark, Kim Jung Ki, Koretz Brandon, Seeman Teresa
Division of Geriatrics, Geffen School of Medicine at UCLA, 10945 Le Conte Avenue, Suite 2339, Los Angeles, California, 90095-1687, USA.
Int J Public Health. 2009;54(3):166-74. doi: 10.1007/s00038-008-7030-4.
To examine education differentials in screening, awareness, treatment and control of hypercholesterolemia overall and in 3 race/ethnic groups.
We analyzed data for a nationally representative sample of 8,429 men and women ages 20 to 85 years, self-reported as white, black, Mexican American, or other race/ethnicity, who participated in the National Health and Nutrition Examination Survey from 1999-2002.
Participants with < high school education were 2.5 times less likely than participants with > or = high school education to have been screened for hypercholesterolemia, after adjusting for age and gender (odds ratio: 0.4, 95 % confidence interval: 0.3-0.5, and similar across race/ethnic group). Multivariable models for awareness, treatment and control showed no significant trends associated with education after adjusting for age, gender, race and comorbidities.
Higher education significantly increased the odds of being screened for hypercholesterolemia overall and within each race/ethnic group. Education differentials were strongest for hypercholesterolemia screening, and weak or no longer apparent for subsequent steps of awareness, treatment and control. Focusing public health policy on increasing screening for individuals with low education might greatly improve their chances of preventing or mitigating morbidity related to hypercholesterolemia and subsequent cardiovascular disease.
总体上以及在3个种族/族裔群体中，研究高胆固醇血症筛查、知晓情况、治疗和控制方面的教育差异。
我们分析了8429名年龄在20至85岁之间、自我报告为白人、黑人、墨西哥裔美国人或其他种族/族裔的男女的数据，这些人参与了1999 - 2002年的国家健康和营养检查调查。
在调整年龄和性别后，接受高中以下教育的参与者接受高胆固醇血症筛查的可能性比接受高中及以上教育的参与者低2.5倍（优势比：0.4，95%置信区间：0.3 - 0.5，且在各种族/族裔群体中相似）。在调整年龄、性别、种族和合并症后，关于知晓情况、治疗和控制的多变量模型显示与教育没有显著关联趋势。
高等教育显著增加了总体上以及每个种族/族裔群体中接受高胆固醇血症筛查的几率。教育差异在高胆固醇血症筛查方面最为明显，而在随后的知晓情况、治疗和控制步骤中则较弱或不再明显。将公共卫生政策重点放在增加对低教育程度个体的筛查上，可能会大大提高他们预防或减轻与高胆固醇血症及后续心血管疾病相关发病几率的机会。
