Department of African American Studies, University of Maryland, College Park, MD.
Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Ann Epidemiol. 2018 Mar;28(3):147-152. doi: 10.1016/j.annepidem.2017.12.007. Epub 2017 Dec 22.
Racial differences in socioeconomic status (SES) explain some, but not all, of racial disparities in cardiovascular disease (CVD) risk. To address this, race disparities among higher SES individuals need to be assessed. The purpose of this study was to assess whether racial disparities in CVD risk factors differ by SES levels.
Data from the National Health and Nutritional Examination Survey 2007-2014 were used to calculate racial differences in hypertension, high cholesterol, diabetes, and obesity. Interactions between race and SES were assessed.
African Americans had higher odds of hypertension (odds ratio [OR], 1.90; 95% confidence interval [CI], 1.72-2.09), diabetes (OR, 1.66; 95% CI, 1.33-2.07), and obesity (OR, 1.64; 95% CI, 1.46-1.83) than whites. Significant interactions between race and income greater than or equal to $100,000 were observed for obesity (OR, 1.55; 95% CI, 1.24-1.94) and between race and education (college graduate or more; OR, 1.58; 95% CI, 1.16-2.15). Disparities in diabetes were observed in the highest SES groups, but not among those in the lowest SES groups.
Race disparities in some CVD risk factors varied by SES levels. Results suggest that race disparities in obesity are larger among those with income greater than or equal to $100,000 and who are college graduates. It is possible that African Americans experience fewer health-related benefits of increased income and education levels compared with whites.
社会经济地位(SES)方面的种族差异解释了部分心血管疾病(CVD)风险的种族差异,但并非全部。为了解决这个问题,需要评估 SES 较高人群中的种族差异。本研究旨在评估 CVD 风险因素的种族差异是否因 SES 水平而异。
使用 2007-2014 年全国健康和营养调查的数据计算高血压、高胆固醇、糖尿病和肥胖症的种族差异。评估了种族与 SES 之间的相互作用。
与白人相比,非裔美国人患高血压(优势比[OR],1.90;95%置信区间[CI],1.72-2.09)、糖尿病(OR,1.66;95% CI,1.33-2.07)和肥胖症(OR,1.64;95% CI,1.46-1.83)的可能性更高。观察到种族与收入大于等于 100,000 美元之间存在显著的相互作用,肥胖症(OR,1.55;95% CI,1.24-1.94)和种族与教育(大学毕业或以上;OR,1.58;95% CI,1.16-2.15)之间存在显著的相互作用。在 SES 最高的群体中观察到糖尿病的差异,但在 SES 最低的群体中没有观察到这种差异。
一些 CVD 风险因素的种族差异因 SES 水平而异。结果表明,收入大于等于 100,000 美元且大学毕业的人群中,肥胖症的种族差异更大。与白人相比,非裔美国人可能从收入和教育水平的提高中获得较少的健康益处。