Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
Department of Health Behavior, Society and Policy, Rutgers University School of Public Health, 683 Hoes Lane West, Room 311, Piscataway Township, NJ, 08854, USA.
J Racial Ethn Health Disparities. 2019 Jun;6(3):463-471. doi: 10.1007/s40615-018-00543-y. Epub 2018 Nov 19.
Heart disease is the leading cause of death in the USA, and there is an extensive literature describing disparities in the treatment of the disease. Cholesterol-lowering medications are an effective strategy for reducing the risk of cardiovascular diseases for many patients, but some who are prescribed these medications fail to take them. We examine data from the 2014 New York City Community Health Survey to investigate the factors that influence why patients are not compliant in following the prescribed regimen. We focus on adults age 45 and older who report that they are diagnosed with elevated cholesterol levels and were told by a health professional they needed to take cholesterol-lowering medication. We find that evident disparities: individuals with low incomes, those who rely on emergency departments for their healthcare, have not received medical care within the past year, are depressed, and identify as black non-Hispanic and Hispanic are less likely to adhere to a cholesterol-lowering medication program. Although Medicare beneficiaries are less likely to take cholesterol-lowering medication than those with private insurance, those who were on Medicaid or were uninsured did not report lower rates of adherence.
心脏病是美国的主要死因，有大量文献描述了该病治疗方面的差异。降胆固醇药物是许多患者降低心血管疾病风险的有效策略，但有些患者未能服用这些药物。我们利用 2014 年纽约市社区健康调查的数据，研究影响患者不遵守规定治疗方案的因素。我们关注的是年龄在 45 岁及以上、报告胆固醇水平升高并被告知需要服用降胆固醇药物的成年人。我们发现存在明显的差异：收入低、依赖急诊室就医、过去一年未接受医疗护理、抑郁以及自认为是非裔西班牙裔或西班牙裔的个体，不太可能坚持降胆固醇药物治疗方案。尽管医疗保险受益人的降胆固醇药物使用率低于私人保险，但那些参加医疗补助计划或没有保险的人报告的遵医率并没有降低。
