Yang Huanhuan, Huang Chenxi, Sawano Mitsuaki, Herrin Jeph, Faridi Kamil F, Li Zhihui, Spatz Erica, Krumholz Harlan M, Lu Yuan
Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut.
Vanke School of Public Health, Tsinghua University, Beijing, China.
JAMA Netw Open. 2025 Jun 2;8(6):e2516663. doi: 10.1001/jamanetworkopen.2025.16663.
Significant racial and ethnic differences exist in Life's Essential 8 (LE8), but the trends in these differences over time are not well understood. Additionally, the key components of LE8 associated with these differences are unclear.
To evaluate trends in racial and ethnic differences in LE8 over a 10-year period and to identify the primary factors associated with the LE8 differences.
DESIGN, SETTING, AND PARTICIPANTS: Serial population-based cross-sectional study of the National Health and Nutrition Examination Survey from 2011 to 2020 that included adults aged 20 to 79 years. The analysis was performed between March and October 2024.
Self-reported race and ethnicity.
Trends in racial and ethnic differences in LE8 and primary factors associated with the differences.
The median (IQR) age of the 16 104 participants was 46 (32-59) years; 8262 (51.1%) were women; 1974 (5.2%) were Asian, 3918 (10.9%) were Black, 4144 (15.7%) were Latino/Hispanic, and 6068 (68.2%) were White. From 2011 to 2020, Asian adults had the highest LE8 score (71.2; 95% CI, 70.3-72.0), followed by White (67.7; 95% CI, 66.9-68.6) and Latino/Hispanic (65.9; 95% CI, 61.3-62.7) adults, and Black adults (62.0) had the lowest LE8 score. These racial and ethnic differences in LE8 overall score did not significantly change from 2011 to 2020. However, the differences in several individual components of LE8 changed significantly. For example, the Latino/Hispanic vs White difference in sleep health score significantly increased, from -1.25 to -4.38, with a descriptive difference-of-differences of -3.12 (95% CI, -5.83 to -0.42; P = .02). In 2017 to 2020, all but blood lipids and nicotine exposure were negatively associated factors (z scores <0) for the Black vs White difference; nicotine exposure was the key positive (z score = 1.01), while physical activity was the key negative (z score = -1.01) factor associated with the Latino/Hispanic vs White difference; nicotine exposure (z score = 2.59) and diet (z score = 2.12) were the primary positive factors associated with Asian vs White difference.
In this cross-sectional study, racial and ethnic differences in overall LE8 scores compared with White adults remained largely unchanged from 2011 to 2020. These differences were associated with varying components across different racial and ethnic groups, emphasizing the need for targeted, group-specific interventions.
生命基本八项指标（LE8）存在显著的种族和民族差异，但这些差异随时间的变化趋势尚不清楚。此外，与这些差异相关的LE8关键组成部分也不明确。
评估10年间LE8种族和民族差异的趋势，并确定与LE8差异相关的主要因素。
设计、设置和参与者：基于2011年至2020年美国国家健康与营养检查调查的系列人群横断面研究，纳入20至79岁的成年人。分析于2024年3月至10月进行。
自我报告的种族和民族。
LE8种族和民族差异的趋势以及与差异相关的主要因素。
16104名参与者的年龄中位数（四分位间距）为46（32 - 59）岁；8262名（51.1%）为女性；1974名（5.2%）为亚洲人，3918名（10.9%）为黑人，4144名（15.7%）为拉丁裔/西班牙裔，6068名（68.2%）为白人。从2011年到2020年，亚洲成年人的LE8得分最高（71.2；95%置信区间，70.3 - 72.0），其次是白人（67.7；95%置信区间，66.9 - 68.6）和拉丁裔/西班牙裔成年人（65.9；95%置信区间，61.3 - 62.7），黑人成年人（62.0）的LE8得分最低。从2011年到2020年，LE8总分的这些种族和民族差异没有显著变化。然而，LE8几个个体组成部分的差异有显著变化。例如，拉丁裔/西班牙裔与白人在睡眠健康得分上的差异显著增加，从 - 1.25增至 - 4.38，描述性差异差值为 - 3.12（95%置信区间， - 5.83至 - 0.42；P = 0.02）。在2017年至2020年，除血脂和尼古丁暴露外，所有因素都是黑人与白人差异的负相关因素（z分数<0）；尼古丁暴露是关键的正相关因素（z分数 = 1.01），而体育活动是与拉丁裔/西班牙裔与白人差异相关的关键负相关因素（z分数 = - 1.01）；尼古丁暴露（z分数 = 2.59）和饮食（z分数 = 2.12）是与亚洲人与白人差异相关的主要正相关因素。
在这项横断面研究中，与白人成年人相比，2011年至2020年LE8总分的种族和民族差异基本保持不变。这些差异与不同种族和民族群体的不同组成部分相关，强调了针对性的、特定群体干预措施的必要性。
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