School of Medicine Johns Hopkins University Baltimore MD.
School of Nursing Johns Hopkins University Baltimore MD.
J Am Heart Assoc. 2021 Dec 7;10(23):e020396. doi: 10.1161/JAHA.121.020396. Epub 2021 Nov 30.
Background Atherosclerotic cardiovascular disease, defined as nonfatal myocardial infarction (MI), coronary heart disease death, or fatal or nonfatal stroke, is the leading cause of death in the United States. MI and stroke symptom awareness and response reduce delays in hospitalization and mortality. Methods and Results We analyzed cross-sectional data from the 2014 and 2017 National Health Interview Surveys on US- and foreign-born adults from 9 regions of birth (Europe, South America, Mexico/Central America/Caribbean, Russia, Africa, Middle East, Indian subcontinent, Asia, and Southeast Asia). The outcomes were recommended MI and stroke knowledge, defined as knowing all 5 symptoms of MI or stroke, respectively, and choosing "call 9-1-1" as the best response. We included 63 059 participants, with a mean age 49.4 years; 54.1% were women, and 38.5% had a high school education or less. Recommended MI and stroke knowledge were highest in US-born people. In both 2014 and 2017, MI knowledge was lowest in individuals born in Asia (23.9%±2.5% and 32.1%±3.3%, respectively), and stroke knowledge lowest for the Indian subcontinent (44.4%±2.4% and 46.0%±3.2%, respectively). Among foreign-born adults, people from Russia and Europe had the highest prevalence of recommended MI knowledge in 2014 (37.4%±5.4%) and 2017 (43.5%±2.5%), respectively, and recommended stroke knowledge was highest in people from Europe (61.0%±2.6% and 67.2%±2.5%). Improvement in knowledge was not significant in all groups between 2014 and 2017. Conclusions These findings suggest a disparity in MI and stroke symptom awareness and response among immigrants in the United States. Culturally tailored public health education and health literacy initiatives are needed to help reduce these disparities in awareness.
动脉粥样硬化性心血管疾病（定义为非致死性心肌梗死（MI）、冠心病死亡或致死性或非致死性卒中）是美国的主要死亡原因。MI 和卒中症状意识及应对可减少住院和死亡的延迟。
我们分析了 2014 年和 2017 年美国国家健康访谈调查中来自 9 个出生地区（欧洲、南美洲、墨西哥/中美洲/加勒比、俄罗斯、非洲、中东、印度次大陆、亚洲和东南亚）的美国和外国出生的成年人的横断面数据。结局为推荐的 MI 和卒中知识，分别定义为知晓 MI 或卒中的全部 5 个症状，以及选择“拨打 9-1-1”为最佳反应。我们纳入了 63059 名参与者，平均年龄为 49.4 岁；54.1%为女性，38.5%受教育程度为高中或以下。美国出生的人群中推荐的 MI 和卒中知识最高。在 2014 年和 2017 年，出生于亚洲的个体的 MI 知识最低（分别为 23.9%±2.5%和 32.1%±3.3%），而出生于印度次大陆的个体的卒中知识最低（分别为 44.4%±2.4%和 46.0%±3.2%）。在外国出生的成年人中，2014 年俄罗斯人和欧洲人的推荐 MI 知识流行率最高（分别为 37.4%±5.4%和 43.5%±2.5%），2017 年欧洲人的推荐卒中知识最高（分别为 61.0%±2.6%和 67.2%±2.5%）。在所有组中，2014 年至 2017 年知识改善不显著。
这些发现表明美国移民的 MI 和卒中症状意识及应对存在差异。需要进行文化上适当的公共卫生教育和健康素养举措，以帮助减少这些意识方面的差异。
