Pharmaceutical Health Outcomes and Policy Department, College of Pharmacy, University of Houston, Texas.
School of Public Health, University of Texas Health Science Center at Houston.
Prev Chronic Dis. 2024 Nov 14;21:E89. doi: 10.5888/pcd21.240264.
Understanding health outcomes among people with cardiovascular disease (CVD) is crucial for improving treatment strategies and patient quality of life. This study investigated racial and ethnic disparities in perceived health status among non-Hispanic Black, Hispanic, and non-Hispanic White adults with CVD.
The study had a retrospective cross-sectional design and used data from the Medical Expenditure Panel Survey spanning 8 calendar years (2014-2021). The study population consisted of adults diagnosed with various CVDs. We used ordinal logistic regression models adjusted for demographic and socioeconomic characteristics, CVD severity, comorbidities, and health care expenditures to assess racial and ethnic differences in perceived health status.
Among the 11,715 (weighted frequency, 15,431,283) adults with CVD, we observed significant differences in perceived health status across racial and ethnic cohorts. The unadjusted analysis showed that non-Hispanic Black adults had significantly higher odds than non-Hispanic White adults of perceiving their health as poorer (odds ratio [OR]= 1.89; 95% CI, 1.74-2.07; P < .001), with a similar observation among Hispanic adults (OR = 2.05; 95% CI, 1.85-2.26; P < .001). Although female sex, higher education, and better income had protective effects on perceived health status independent of race, we found significant racial and ethnic differences in the effect of older age, physical and cognitive limitations, and health insurance status on perceived health status.
This study revealed substantial racial disparities in perceived health status among adults with CVD, with notable differences in the effects of predictive factors. Addressing these disparities requires targeted interventions to improve health care access and enhance socioeconomic conditions tailored to the needs and experiences of racial and ethnic populations.
了解心血管疾病（CVD）患者的健康结果对于改善治疗策略和患者生活质量至关重要。本研究调查了非西班牙裔黑种人、西班牙裔和非西班牙裔白种人 CVD 患者感知健康状况的种族和民族差异。
本研究采用回顾性横断面设计，使用了医疗支出面板调查（Medical Expenditure Panel Survey）在 8 个日历年内（2014-2021 年）的数据。研究人群包括被诊断患有各种 CVD 的成年人。我们使用有序逻辑回归模型，根据人口统计学和社会经济特征、CVD 严重程度、合并症和医疗保健支出进行调整，以评估感知健康状况的种族和民族差异。
在 11715 名（加权频率为 15431283 名）患有 CVD 的成年人中，我们观察到不同种族和族裔群体之间的感知健康状况存在显著差异。未经调整的分析表明，非西班牙裔黑种人成年人比非西班牙裔白种人成年人更有可能认为自己的健康状况较差（优势比[OR] = 1.89；95%置信区间[CI]，1.74-2.07；P <.001），西班牙裔成年人也存在类似的观察结果（OR = 2.05；95%CI，1.85-2.26；P <.001）。尽管女性性别、较高的教育程度和更好的收入对感知健康状况具有保护作用，独立于种族，但我们发现，年龄较大、身体和认知障碍以及健康保险状况对感知健康状况的影响存在显著的种族和民族差异。
本研究揭示了 CVD 患者感知健康状况存在显著的种族差异，且预测因素的影响存在显著差异。解决这些差异需要有针对性的干预措施，以改善医疗保健的可及性，并根据种族和民族群体的需求和经验，增强社会经济条件。
