Equalizing midlife socioeconomic status would reduce cardiovascular health disparities by 64% between White men and Black men, and 60% between White men and Black women.
Observational (n=1,948)
Yes
Does equalizing early-life adversities, perceived discrimination, or midlife socioeconomic status reduce cardiovascular health disparities at the intersection of race and gender?
Equalizing midlife socioeconomic status and early-life adversities could substantially reduce racial and gender disparities in cardiovascular health.
Effect estimate: 64% reduction in disparity (White men vs Black men for midlife SES)
OBJECTIVES: Cardiovascular health (CVH) is associated with reductions in age-related disease and later-life mortality. Black adults, particularly Black women, are less likely to achieve ideal CVH. Guided by intersectionality and life-course approaches, we examine to what degree (a) disparities in CVH exist at the intersection of race and gender and (b) CVH disparities would be reduced if marginalized groups had the same levels of resources and adversities as privileged groups. METHODS: We used biomarker subsamples from the Midlife in the United States Core and Refresher studies (N = 1,948). Causal decomposition analysis was implemented to test hypothetical interventions to equalize the distribution of early-life adversities (ELAs), perceived discrimination, or midlife socioeconomic status (SES) between marginalized and privileged groups. We conducted sensitivity analyses to determine to what degree unmeasured confounders would invalidate our findings. RESULTS: White women have the highest CVH score, followed by White men, Black men, and Black women. Intervening on ELAs would reduce the disparities: White men versus Black women (30% reduction) and White women versus Black women (15%). Intervening on perceived discrimination would not substantially change initial disparities. Intervening on midlife SES would yield large disparity reductions: White men versus Black men (64%), White men versus Black women (60%), and White women versus Black women (27%). These reductions are robust to unmeasured confounders. DISCUSSION: Providing economic security in adulthood for Blacks may help reduce racial disparities in CVH. Preventing exposure to ELAs among Black women may reduce their vulnerability to cardiovascular disease, compared to White adults.
Lee et al. (Tue,) conducted a observational in Cardiovascular health disparities (n=1,948). Early-life adversities, perceived discrimination, and midlife socioeconomic status vs. Privileged groups (White adults) was evaluated on Cardiovascular health disparities (64% reduction in disparity (White men vs Black men for midlife SES)). Equalizing midlife socioeconomic status would reduce cardiovascular health disparities by 64% between White men and Black men, and 60% between White men and Black women.