Race alone may not explain CVD risk disparities
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Environmental, psychological and social factors may play a larger role than race alone in contributing to health disparities associated with CVD risk factors, according to research presented at the American Heart Association Epidemiology, Prevention, Lifestyle and Cardiometabolic Health Scientific Sessions.
In an analysis of independent CVD risk factors that compared white individuals with African American, African immigrant and African Caribbean individuals in the U.S., researchers observed that:
- African immigrants (mean age, 41 years) were less likely to be insured (76%) compared with white (91%) and African American individuals (83%; P .001).
- African immigrants we more likely to be college educated (36%) compared with African Caribbean (23%), African American (17%) and white individuals (32%; P .001).
- Hypertension was less prevalent among African immigrants (17%) compared with African Caribbean (32%), African American (42%) and white individuals (34%).
- Smoking was less prevalent among African immigrants (5%) compared with African Caribbean (8%), African American (18%) and white individuals (16%).
- Diabetes was less prevalent among African immigrants (9%) compared with African Caribbean (19%), African American (15%) and white individuals (10%).
- Obesity was less prevalent among African immigrants (60%) compared with African Caribbean (68%), African American (76%) and white individuals (66%).
“The study shows that race alone doesn’t account for risk factor differences between blacks and whites,” Diana Baptiste, DNP, RN, CNE, assistant professor at the Johns Hopkins University School of Nursing, said in a press release. “Among all the groups, African immigrants, who have the highest degree of African ancestry, had the lowest burden of risk factors.”
In other findings, trends for obesity and diabetes increased among African American and white individuals between 2010 and 2018 (P for trend < .001).
In addition, smoking was more prevalent in white and African American individuals compared with African immigrants and African Caribbean individuals but decreased during the study period (P for trend < .001).
For this comparative analysis using data from the National Health Interview Survey, researchers assessed a cohort of 82,835 black (89% African American; 5% African immigrant; 6% African Caribbean) and 370,362 white participants to determine trends in self-reported CVD risk factors.
“The strength of the study was the amount of data available for a large group of people. However, only 5% of the study group were African immigrants and only 8% were Afro-Caribbeans, so it is not possible to extrapolate these findings to the U.S. population of black Americans or people of African ancestry in general,” Ivor Benjamin, MD, FAHA, past president of the AHA and director of the cardiovascular center at the Medical College of Wisconsin, Milwaukee, said in the release. “For example, African immigrants in this study tended to be younger and better educated, which correlates with better heart health. That doesn’t mean it would be true for the hundreds of millions of people living in Africa or in the Caribbean.” – by Scott Buzby
Reference:
Baptiste D, et al. Presentation 08. Presented at: American Heart Association Epidemiology, Prevention, Lifestyle and Cardiometabolic Health Scientific Sessions; March. 3-6, 2020; Phoenix.
Disclosures: The authors report no relevant financial disclosures.