TY - JOUR
T1 - Association of Socioeconomic Status With Life’s Essential 8 Varies by Race and Ethnicity
AU - Williams, Amaris
AU - Nolan, Timiya S.
AU - Brock, Guy
AU - Garner, Jennifer
AU - Brewer, Laprincess C.
AU - Sanchez, Eduardo J.
AU - Joseph, Joshua J.
N1 - Publisher Copyright:
© 2023 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
PY - 2023/9/19
Y1 - 2023/9/19
N2 - BACKGROUND: The American Heart Association’s Life’s Essential 8 (LE8) are 8 risk factors for cardiovascular disease, with poor attainment across all racial, ethnic, and socioeconomic groups. Attainment is lowest among Americans of low socioeconomic status (SES). Evidence suggests the association of SES with LE8 may vary by race and ethnicity. METHODS AND RESULTS: The association of 4 SES categories (education, income-to-poverty line ratio, employment, insur-ance) with LE8 was computed in age-adjusted linear regression models, with an interaction term for race and ethnicity, using National Health and Nutrition Examination Survey data, years 2011 to 2018. The sample (n=13 529) had a median age of 48 years (51% female) with weighting to be representative of the US population. The magnitude of positive association of college education (relative to ≤high school) with LE8 was greater among non-Hispanic White Americans (NHWA) compared with non-Hispanic Black Americans, Hispanic Americans, and non-Hispanic Asian Americans (all interactions P<0.001). NHWA had a greater magnitude of positive association of income-to-poverty line ratio with LE8, compared with non-Hispanic Black Americans, Hispanic Americans, and non-Hispanic Asian Americans (all interactions P<0.001). NHWA with Medicaid compared with private insurance had a greater magnitude of negative association with LE8 compared with non-Hispanic Black Americans, non-Hispanic Asian Americans, or Hispanic Americans (all interactions P<0.01). NHWA unemployed due to disability or health condition (compared with employed) had a greater magnitude of negative association with LE8 than non-Hispanic Black Americans, non-Hispanic Asian Americans, or Hispanic Americans (all interactions P<0.05). CONCLUSIONS: The magnitude of association of SES with LE8 is greatest among NHWA. More research is needed on SES’s role in LE8 attainment in minority group populations.
AB - BACKGROUND: The American Heart Association’s Life’s Essential 8 (LE8) are 8 risk factors for cardiovascular disease, with poor attainment across all racial, ethnic, and socioeconomic groups. Attainment is lowest among Americans of low socioeconomic status (SES). Evidence suggests the association of SES with LE8 may vary by race and ethnicity. METHODS AND RESULTS: The association of 4 SES categories (education, income-to-poverty line ratio, employment, insur-ance) with LE8 was computed in age-adjusted linear regression models, with an interaction term for race and ethnicity, using National Health and Nutrition Examination Survey data, years 2011 to 2018. The sample (n=13 529) had a median age of 48 years (51% female) with weighting to be representative of the US population. The magnitude of positive association of college education (relative to ≤high school) with LE8 was greater among non-Hispanic White Americans (NHWA) compared with non-Hispanic Black Americans, Hispanic Americans, and non-Hispanic Asian Americans (all interactions P<0.001). NHWA had a greater magnitude of positive association of income-to-poverty line ratio with LE8, compared with non-Hispanic Black Americans, Hispanic Americans, and non-Hispanic Asian Americans (all interactions P<0.001). NHWA with Medicaid compared with private insurance had a greater magnitude of negative association with LE8 compared with non-Hispanic Black Americans, non-Hispanic Asian Americans, or Hispanic Americans (all interactions P<0.01). NHWA unemployed due to disability or health condition (compared with employed) had a greater magnitude of negative association with LE8 than non-Hispanic Black Americans, non-Hispanic Asian Americans, or Hispanic Americans (all interactions P<0.05). CONCLUSIONS: The magnitude of association of SES with LE8 is greatest among NHWA. More research is needed on SES’s role in LE8 attainment in minority group populations.
KW - cardiovascular disease
KW - ethnicity
KW - primordial prevention
KW - race
KW - risk factors
KW - socioeconomic status
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U2 - 10.1161/JAHA.122.029254
DO - 10.1161/JAHA.122.029254
M3 - Article
C2 - 37702137
AN - SCOPUS:85171761079
SN - 2047-9980
VL - 12
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 18
M1 - e029254
ER -