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
Related Article:
Circulation 2005 111: 1203.
This article has been cited by other articles:
 |
|
 |
|
  S. K. Kumanyika, E. Obarzanek, N. Stettler, R. Bell, A. E. Field, S. P. Fortmann, B. A. Franklin, M. W. Gillman, C. E. Lewis, W. C. Poston II, et al. Population-Based Prevention of Obesity: The Need for Comprehensive Promotion of Healthful Eating, Physical Activity, and Energy Balance: A Scientific Statement From American Heart Association Council on Epidemiology and Prevention, Interdisciplinary Committee for Prevention (Formerly the Expert Panel on Population and Prevention Science) Circulation, July 22, 2008; 118(4): 428 - 464. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C Fornari, G C Cesana, L E Chambless, G Corrao, R Borchini, F Madotto, M M Ferrario, and for the MONICA Brianza-CAMUNI Research Group Time trends of myocardial infarction 28-day case-fatality in the 1990s: is there a contribution from different changes among socioeconomic classes? J Epidemiol Community Health, July 1, 2008; 62(7): 593 - 598. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Mehrotra, D. Kermah, L. Fried, S. Adler, and K. Norris Racial Differences in Mortality Among Those with CKD J. Am. Soc. Nephrol., July 1, 2008; 19(7): 1403 - 1410. [Full Text] [PDF]
|
|
|
|
 |
|
 A. K. Mwachofi and R. Broyles Is Minority Status a More Consistent Predictor of Disability Than Socioeconomic Status? Journal of Disability Policy Studies, June 1, 2008; 19(1): 34 - 43. [Abstract] [PDF]
|
|
|
|
 |
|
 A. Razmara, L. Sunday, C. Stirone, X. B. Wang, D. N. Krause, S. P. Duckles, and V. Procaccio Mitochondrial Effects of Estrogen Are Mediated by Estrogen Receptor {alpha} in Brain Endothelial Cells J. Pharmacol. Exp. Ther., June 1, 2008; 325(3): 782 - 790. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. W. Yancy, W. T. Abraham, N. M. Albert, R. Clare, W. G. Stough, M. Gheorghiade, B. H. Greenberg, C. M. O'Connor, L. She, J. L. Sun, et al. Quality of Care of and Outcomes for African Americans Hospitalized With Heart Failure: Findings From the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure) Registry J. Am. Coll. Cardiol., April 29, 2008; 51(17): 1675 - 1684. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. Allison, M. J. Budoff, N. D. Wong, R. S. Blumenthal, P. J. Schreiner, and M. H. Criqui Prevalence of and Risk Factors for Subclinical Cardiovascular Disease in Selected US Hispanic Ethnic Groups: The Multi-Ethnic Study of Atherosclerosis Am. J. Epidemiol., April 15, 2008; 167(8): 962 - 969. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. J. Lederer, E. K. T. Benn, R. G. Barr, J. S. Wilt, G. Reilly, J. R. Sonett, S. M. Arcasoy, and S. M. Kawut Racial Differences in Waiting List Outcomes in Chronic Obstructive Pulmonary Disease Am. J. Respir. Crit. Care Med., February 15, 2008; 177(4): 450 - 454. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Rosamond, K. Flegal, K. Furie, A. Go, K. Greenlund, N. Haase, S. M. Hailpern, M. Ho, V. Howard, B. Kissela, et al. Heart Disease and Stroke Statistics--2008 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Circulation, January 29, 2008; 117(4): e25 - e146. [Full Text] [PDF]
|
|
|
|
 |
|
 S. Nguyen, C. McCulloch, P. Brakeman, A. Portale, and C.-y. Hsu Being Overweight Modifies the Association Between Cardiovascular Risk Factors and Microalbuminuria in Adolescents Pediatrics, January 1, 2008; 121(1): 37 - 45. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Sweet, T. W. McDade, C. I. Kiefe, and K. Liu Relationships Between Skin Color, Income, and Blood Pressure Among African Americans in the CARDIA Study Am J Public Health, December 1, 2007; 97(12): 2253 - 2259. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A Steptoe, A Shamaei-Tousi, A Gylfe, B Henderson, S Bergstrom, and M Marmot Socioeconomic status, pathogen burden and cardiovascular disease risk Heart, December 1, 2007; 93(12): 1567 - 1570. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. T. Hirsch, T. P. Murphy, M. B. Lovell, G. Twillman, D. Treat-Jacobson, E. M. Harwood, E. R. Mohler III, M. A. Creager, R. W. Hobson II, R. M. Robertson, et al. Gaps in Public Knowledge of Peripheral Arterial Disease: The First National PAD Public Awareness Survey Circulation, October 30, 2007; 116(18): 2086 - 2094. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. A. Talegawkar, E. J. Johnson, T. Carithers, H. A. Taylor Jr., M. L. Bogle, and K. L. Tucker Total {alpha}-Tocopherol Intakes Are Associated with Serum {alpha}-Tocopherol Concentrations in African American Adults J. Nutr., October 1, 2007; 137(10): 2297 - 2303. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. Papas, A. J. Alberg, R. Ewing, K. J. Helzlsouer, T. L. Gary, and A. C. Klassen The Built Environment and Obesity Epidemiol. Rev., May 28, 2007; (2007) mxm009v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Wang and M. A. Beydoun The Obesity Epidemic in the United States--Gender, Age, Socioeconomic, Racial/Ethnic, and Geographic Characteristics: A Systematic Review and Meta-Regression Analysis Epidemiol. Rev., May 17, 2007; (2007) mxm007v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. O. Clark, T. E. Stump, D. K. Miller, and J. S. Long Educational Disparities in the Prevalence and Consequence of Physical Vulnerability J. Gerontol. B. Psychol. Sci. Soc. Sci., May 1, 2007; 62(3): S193 - S197. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Melikian, S. B. Wheatcroft, O. S. Ogah, C. Murphy, P. J. Chowienczyk, A. S. Wierzbicki, T. A.B. Sanders, B. Jiang, E. R. Duncan, A. M. Shah, et al. Asymmetric Dimethylarginine and Reduced Nitric Oxide Bioavailability in Young Black African Men Hypertension, April 1, 2007; 49(4): 873 - 877. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Hozawa, A. R. Folsom, A. R. Sharrett, and L. E. Chambless Absolute and Attributable Risks of Cardiovascular Disease Incidence in Relation to Optimal and Borderline Risk Factors: Comparison of African American With White Subjects--Atherosclerosis Risk in Communities Study Arch Intern Med, March 26, 2007; 167(6): 573 - 579. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Rosamond, K. Flegal, G. Friday, K. Furie, A. Go, K. Greenlund, N. Haase, M. Ho, V. Howard, B. Kissela, et al. Heart Disease and Stroke Statistics--2007 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Circulation, February 6, 2007; 115(5): e69 - e171. [Full Text] [PDF]
|
|
|
|
 |
|
 J. C. Wells Commentary: Why are South Asians susceptible to central obesity? -- the El Nino hypothesis Int. J. Epidemiol., February 1, 2007; 36(1): 226 - 227. [Full Text] [PDF]
|
|
|
|
 |
|
 G. A. Mensah and D. W. Brown An Overview Of Cardiovascular Disease Burden In The United States Health Aff., January 1, 2007; 26(1): 38 - 48. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Stecker, J. C. Fortney, D. E. Steffick, and S. Prajapati The Triple Threat for Chronic Disease: Obesity, Race, and Depression Psychosomatics, December 1, 2006; 47(6): 513 - 518. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J O'Loughlin, E Dugas, K Maximova, and N Kishchuk Reporting of ethnicity in research on chronic disease: update Postgrad. Med. J., November 1, 2006; 82(973): 737 - 742. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Tillin, N. G. Forouhi, P. M. McKeigue, and N. Chaturvedi The Role of Diabetes and Components of the Metabolic Syndrome in Stroke and Coronary Heart Disease Mortality in U.K. White and African-Caribbean Populations. Diabetes Care, September 1, 2006; 29(9): 2127 - 2129. [Full Text] [PDF]
|
|
|
|
|
|
C. Brown, K. A. Matthews, J. T. Bromberger, and Y. Chang The Relation between Perceived Unfair Treatment and Blood Pressure in a Racially/Ethnically Diverse Sample of Women Am. J. Epidemiol., August 1, 2006; 164(3): 257 - 262. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. El-Saed, L. H. Kuller, A. B. Newman, O. Lopez, J. Costantino, K. McTigue, M. Cushman, and R. Kronmal Geographic Variations in Stroke Incidence and Mortality Among Older Populations in Four US Communities Stroke, August 1, 2006; 37(8): 1975 - 1979. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Albert and P. M Ridker C-Reactive Protein as a Risk Predictor: Do Race/Ethnicity and Gender Make a Difference? Circulation, August 1, 2006; 114(5): e67 - e74. [Full Text] [PDF]
|
|
|
|
 |
|
 B. Schouten, A. M. Bohnen, and S. Thomas Erectile dysfunction and incidence of cardiovascular disease. JAMA, May 3, 2006; 295(17): 1999 - 1999. [Full Text] [PDF]
|
|
|
|
|
|
C. Lorenzo, K. Williams, K. J. Hunt, and S. M. Haffner Trend in the prevalence of the metabolic syndrome and its impact on cardiovascular disease incidence: the san antonio heart study. Diabetes Care, March 1, 2006; 29(3): 625 - 630. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Thom, N. Haase, W. Rosamond, V. J. Howard, J. Rumsfeld, T. Manolio, Z.-J. Zheng, K. Flegal, C. O'Donnell, S. Kittner, et al. Heart Disease and Stroke Statistics--2006 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Circulation, February 14, 2006; 113(6): e85 - e151. [Full Text] [PDF]
|
|
|
|
|
|
L. Mosca, H. Mochari, A. Christian, K. Berra, K. Taubert, T. Mills, K. A. Burdick, and S. L. Simpson National Study of Women's Awareness, Preventive Action, and Barriers to Cardiovascular Health Circulation, January 31, 2006; 113(4): 525 - 534. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Clark, R. A. Benkert, and J. M. Flack Violence Exposure and Optimism Predict Task-Induced Changes in Blood Pressure and Pulse Rate in a Normotensive Sample of Inner-City Black Youth Psychosom Med, January 1, 2006; 68(1): 73 - 79. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. R. Kressin Separate but Not Equal: The Consequences of Segregated Health Care Circulation, October 25, 2005; 112(17): 2582 - 2584. [Full Text] [PDF]
|
|
|
|
|
|
T. S. Harwell, C. S. Oser, N. J. Okon, C. C. Fogle, S. D. Helgerson, and D. Gohdes Defining Disparities in Cardiovascular Disease for American Indians: Trends in Heart Disease and Stroke Mortality Among American Indians and Whites in Montana, 1991 to 2000 Circulation, October 11, 2005; 112(15): 2263 - 2267. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Stirone, S. P. Duckles, D. N. Krause, and V. Procaccio Estrogen Increases Mitochondrial Efficiency and Reduces Oxidative Stress in Cerebral Blood Vessels Mol. Pharmacol., October 1, 2005; 68(4): 959 - 965. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Young Racial, ethnic minorities less likely to receive good cardiac care, studies find Am. J. Health Syst. Pharm., May 1, 2005; 62(9): 886 - 889. [Full Text] [PDF]
|
|
|
|
|
|
R. O. Bonow, A. O. Grant, and A. K. Jacobs The Cardiovascular State of the Union: Confronting Healthcare Disparities Circulation, March 15, 2005; 111(10): 1205 - 1207. [Full Text] [PDF]
|
|