Key result
Lower SES is linked to ~9-point lower cardiovascular health scores in Black Americans, particularly women.
Why the study?
Potential sex differences in the association between socioeconomic status and cardiovascular health remain incompletely understood in Black Americans.
Does lower socioeconomic status reduce cardiovascular health scores in Black American men and women?
Cross-Sectional (n=4,074)
No
Does lower socioeconomic status reduce cardiovascular health scores in Black American men and women?
Socioeconomic status disparities significantly impact cardiovascular health in Black Americans, with women experiencing a steeper gradient of health decline at lower income and education levels.
Answers are grounded in this paper and cite their sources.
Lower SES associated with worse CVH in Black Americans, steeper in women; hypothesis-generating and requires longitudinal confirmation before practice implications.
Background Socioeconomic status (SES) is associated with cardiovascular health (CVH). Potential differences by sex in this association remain incompletely understood in Black Americans, where SES disparities are posited to be partially responsible for cardiovascular inequities. The association of SES measures (income, education, occupation, and insurance) with CVH scores was examined in the Jackson Heart Study. Methods and Results American Heart Association CVH components (non–high‐density‐lipoprotein cholesterol, blood pressure, diet, tobacco use, physical activity, sleep, glycemia, and body mass index) were scored cross‐sectionally at baseline (scale: 0–100). Differences in CVH and 95% CIs (Estimate, 95% CI) were calculated using linear regression, adjusting for age, sex, and discrimination. Heterogeneity by sex was assessed. Participants had a mean age of 54.8 years (SD 12.6 years), and 65% were women. Lower income, education, occupation (non‐management/professional versus management/professional occupations), and insurance status (uninsured, Medicaid, Veterans Affairs, or Medicare versus private insurance) were associated with lower CVH scores (all P <0.01). There was heterogeneity by sex, with greater magnitude of associations of SES measures with CVH in women versus men. The lowest education level (<high school) versus highest (>high school) was associated with 8.8‐point lower (95% CI: −10.2 to −7.3) and 5.4‐point lower (95% CI: −7.2 to −3.6) CVH scores in women and men, respectively (interaction P =0.003). The lowest (<25 000) versus highest level of income (≥$75 000) was associated with a greater reduction in CVH scores in women than men (interaction P =0.1142). Conclusions Among Black Americans, measures of SES were associated with CVH, with a greater magnitude in women compared with men for education and income. Interventions aimed to address CVH through SES should consider the role of sex.
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Joseph et al. (2023) conducted a cross-sectional in General population (Black Americans) (n=4,074). Lower socioeconomic status (income, education, occupation, insurance) vs. Higher socioeconomic status was evaluated on Life's Essential 8 (LE8) score (8.8-point lower, 95% CI -10.2 to -7.3, p=0.003 for interaction). Lower socioeconomic status was associated with lower cardiovascular health scores in Black Americans, with a significantly greater magnitude of association for education and income in women compared to men.
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