The Ohio State University College of Medicine Columbus OH.
The Ohio State University College of Nursing Columbus OH.
J Am Heart Assoc. 2021 Dec 7;10(23):e020184. doi: 10.1161/JAHA.120.020184. Epub 2021 Nov 24.
Background 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. Methods and Results 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 (=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 <0.05). Education and employment status were not associated with higher attainment of ICH in Black men. Conclusions 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.
在美国，黑人群体心血管疾病风险较高，全因死亡率最高。社会经济地位（SES）与大多数人群心血管风险因素的改善相关，但在黑人群体中，相关数据却很少。
我们研究了 SES 指标（包括教育程度、年收入、就业状况和医疗保险状况）与非裔美国男性健康行走计划中的理想心血管健康（ICH）评分之间的关系，ICH 评分包括血压、血糖、胆固醇、体重指数、身体活动和吸烟。6 项 ICH 指标被分为 3 个层次的 ICH 评分，0 至 2 分、3 至 4 分和 5 至 6 分。采用多项逻辑回归模型，在调整年龄因素后，检验 SES 指标与 ICH 评分之间的关系。在 1444 名男性中，有 7%达到了 5 至 6 项 ICH 指标。年收入<$20000 与达到 3 至 4 项 ICH 指标的可能性比达到 0 至 2 项 ICH 指标的可能性低 56%，而年收入≥$75000 与达到 0 至 2 项 ICH 指标的可能性比达到 3 至 4 项 ICH 指标的可能性低 56%（=0.016）。与私人保险相比，医疗保险和没有保险与达到 3 至 4 项 ICH 指标的可能性分别低 39%和 35%，而达到 0 至 2 项 ICH 指标的可能性低 39%和 35%（均<0.05）。教育程度和就业状况与 ICH 的高达成率无关。
在社区居住的黑人群体中，SES 指标的较高达成率与 ICH 较高达成率之间存在混合关联。较高的教育程度和就业状况与 ICH 之间的关联缺乏关联，这表明为了解决影响黑人群体的长期健康不平等问题，增加心血管健康的实现途径可能需要解决 SES 以外的其他因素。
