doi: 10.1161/01.CIR.0000158136.76824.04
(Circulation. 2005;111:1233-1241.)
© 2005 American Heart Association, Inc.
Epidemiology |
State of Disparities in Cardiovascular Health in the United States
From the Office of the Director (G.A.M.) and Behavioral Surveillance Branch (A.H.M., E.S.F.) and Cardiovascular Health Branch (K.J.G., J.B.C.), Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control, Atlanta, Ga.
Correspondence to George A. Mensah, MD, Office of the Director, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Mail Stop K-40, 4770 Buford Hwy NE, Atlanta, GA 30341-3717. E-mail ghm8{at}cdc.gov
Received December 14, 2004; accepted January 24, 2005.
Background— Reducing health disparities remains a major public health challenge in the United States. Having timely access to current data on disparities is important for policy and program development. Accordingly, we assessed the current magnitude of disparities in cardiovascular disease (CVD) and its risk factors in the United States.
Methods and Results— Using national surveys, we determined CVD and risk factor prevalence and indexes of morbidity, mortality, and overall quality of life in adults 
18 years of age by race/ethnicity, sex, education level, socioeconomic status, and geographic location. Disparities were common in all risk factors examined. In men, the highest prevalence of obesity (29.2%) was found in Mexican Americans who had completed a high school education. Black women with or without a high school education had a high prevalence of obesity (47.3%). Hypertension prevalence was high among blacks (39.8%) regardless of sex or educational status. Hypercholesterolemia was high among white and Mexican American men and white women in both groups of educational status. Ischemic heart disease and stroke were inversely related to education, income, and poverty status. Hospitalization was greater in men for total heart disease and acute myocardial infarction but greater in women for congestive heart failure and stroke. Among Medicare enrollees, congestive heart failure hospitalization was higher in blacks, Hispanics, and American Indians/Alaska Natives than among whites, and stroke hospitalization was highest in blacks. Hospitalizations for congestive heart failure and stroke were highest in the southeastern United States. Life expectancy remains higher in women than men and higher in whites than blacks by 
5 years. CVD mortality at all ages tended to be highest in blacks.
Conclusions— Disparities in CVD and related risk factors remain pervasive. The data presented here can be invaluable for policy development and in the planning, implementation, and evaluation of interventions designed to eliminate health disparities.
Key Words: ethnic groups • life expectancy • mortality • quality of life • continental population groups
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