Niakouei Ava, Tehrani Minoo, Fulton Lawrence
College of Liberal Arts & Sciences, University of North Carolina Charlotte, Charlotte, NC 28223, USA.
Mario J. Gabelli School of Business, Roger Williams University, Bristol, RI 02809, USA.
Healthcare (Basel). 2020 Mar 22;8(1):65. doi: 10.3390/healthcare8010065.
The number one leading cause of death in 2017 for Americans was cardiovascular disease (CVD), and health disparities can exacerbate risks. This study evaluates the 2018 Behavioral Risk Factor Surveillance System (BRFSS) ( = 437,436) to estimate population risks for behavioral, socio-economic, psychological, and biological factors. A general linear model with a quasi-binomial link function indicated higher risks for the following groups: smokers (odds ratio, OR = 0.688), individuals with higher body mass index scores (OR = 1.023), persons unable to work (OR = 2.683), individuals with depression (OR = 1.505), workers who missed more days due to mental issues (OR = 1.12), the elderly, males (OR = 1.954), those in race categories "indigenous Americans, Alaskan non-Hispanics", "Black Hispanics," or "other, non-Hispanic," and individuals with lower income. Surprisingly, increased consumption of alcohol was not found to be a risk factor as in other studies. Additional study of alcohol risk factors is needed. Further, Black non-Hispanics were associated with lower rates of CVD/MI (myocardial infarction), a finding that is supported by recent evidence of more unhealthy behaviors in other races. The results of this study highlight 2018 CVD/MI disparities based on the BRFSS and suggest the need for additional policy interventions including education and providing increased access to health care for the disadvantaged. The principles of beneficence and justice require policy interventions such as these.
2017年美国人的头号死因是心血管疾病(CVD),健康差距会加剧风险。本研究评估了2018年行为风险因素监测系统(BRFSS)(n = 437,436),以估计行为、社会经济、心理和生物因素的人群风险。具有拟二项链接函数的一般线性模型表明以下人群的风险较高:吸烟者(优势比,OR = 0.688)、体重指数得分较高的个体(OR = 1.023)、无法工作的人(OR = 2.683)、患有抑郁症的个体(OR = 1.505)、因精神问题缺勤天数更多的工人(OR = 1.12)、老年人、男性(OR = 1.954)、种族类别为“美国原住民、阿拉斯加非西班牙裔”、“黑人西班牙裔”或“其他、非西班牙裔”的人以及收入较低的个体。令人惊讶的是,与其他研究不同,未发现酒精消费增加是一个风险因素。需要对酒精风险因素进行进一步研究。此外,非西班牙裔黑人的CVD/心肌梗死(MI)发病率较低,这一发现得到了近期其他种族存在更多不健康行为证据的支持。本研究结果突出了基于BRFSS的2018年CVD/MI差距,并表明需要采取更多政策干预措施,包括教育以及为弱势群体提供更多获得医疗保健的机会。善和正义的原则要求采取这样的政策干预措施。