Socioeconomic status and trends in disparities in 4 major risk factors for cardiovascular disease among US adults, 1971-2002
Abstract
Background It is unknown whether the previously recognized disparities in cardiovascular disease (CVD) risk factors related to annual income and educational level have diminished, persisted, or worsened in recent decades. The objective of this study was to examine 31-year trends in CVD risk factors by annual income and educational levels among US adults. Methods Four cross-sectional national surveys were used: National Health and Nutrition Examination Survey I (1971-1974), II (1976-1980), III (1988-1994), and 1999-2002. The main outcome measure was prevalence of high cholesterol (> or =240 mg/dL [> or =6.2 mmol/L]), high blood pressure (140/90 mm Hg), smoking, and diabetes mellitus. Results Between 1971 and 2002, the prevalence of all CVD risk factors, except diabetes, decreased in all income and education groups, but there has been little reduction in income- and education-related disparities in CVD risk factors and few improvements during the past 10 years. The prevalence of high blood pressure declined by about half in all income and education groups, ranging from 30.3% to 40.6% in 1971-1974 and 16.4% in 1999-2002, with the greatest reduction among those in the lowest income quartile and those with less than a high school education (18.0 and 15.9 percentage points, respectively). High cholesterol prevalence also declined in all groups and ranged from 28.8% to 32.4% in 1971-1974 and 15.3% to 22.0% in 1999-2002, with the largest decline (15.9 percentage points) among people…
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Lower SES has been associated with increased prevalence of risk factors, such as hypertension, hyperlipidemia, obesity, smoking and physical activity.
“Additionally, lower SES has been associated with increased prevalence of risk factors, such as hypertension, hyperlipidemia, obesity, smoking and physical activity [8], [9], [10], [11], [12].”
From Income disparity and utilization of cardiovascular preventive care services among U.S. adults (2021) · cites this paper as [8]
Disparities between socioeconomic classes have worsened in recent decades.
“These disparities between socioeconomic classes have only worsened in recent decades [8,24].”
From Income disparity and utilization of cardiovascular preventive care services among U.S. adults (2021) · cites this paper as [8]
Cites
Socioeconomic factors and cardiovascular disease: a review of the literature.
Kaplan, G. A., & Keil, J. E. (1993) · Circulation · doi:10.1161/01.cir.88.4.1973 · Cited by 1,845 · see citing works
Mackenbach, J. P., & Kunst, A. E. (1997) · Social Science & Medicine · doi:10.1016/s0277-9536(96)00073-1 · Cited by 1,343 · see citing works
Newell, S. A., Girgis, A., Sanson-Fisher, R. W., & Savolainen, N. J. (1999) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(99)00069-0 · Cited by 379 · see citing works
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Socioeconomic Disparities in Health in the United States: What the Patterns Tell Us
Braveman, P. A., Cubbin, C., Egerter, S., Williams, D. R., & Pamuk, E. (2010) · American Journal of Public Health · doi:10.2105/ajph.2009.166082 · Cited by 1,548 · see citing works
Havranek, E. P., Mujahid, M. S., Barr, D. A., Blair, I. V., Cohen, M. S., Cruz-Flores, S., Davey-Smith, G., Dennison-Himmelfarb, C. R., Lauer, M. S., Lockwood, D. W., et al. (2015) · Circulation · doi:10.1161/cir.0000000000000228 · Cited by 1,472 · see citing works
McWilliams, J. M., Meara, E., Zaslavsky, A. M., & Ayanian, J. Z. (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-150-8-200904210-00005 · Cited by 315 · see citing works
Economic constraints on taste formation and the true cost of healthy eating
Daniel, C. (2016) · Social Science & Medicine · doi:10.1016/j.socscimed.2015.11.025 · Cited by 231 · see citing works
Danaei, G., Rimm, E. B., Oza, S., Kulkarni, S. C., Murray, C. J. L., & Ezzati, M. (2010) · PLoS Medicine · doi:10.1371/journal.pmed.1000248 · Cited by 191 · see citing works
Odutayo, A., Gill, P., Shepherd, S., Akingbade, A., Hopewell, S., Tennankore, K., Hunn, B. H., & Emdin, C. A. (2017) · JAMA Cardiology · doi:10.1001/jamacardio.2017.1658 · Cited by 155 · see citing works
Smits, J. A. J., Zvolensky, M. J., Davis, M. L., Rosenfield, D., Marcus, B. H., Church, T. S., Powers, M. B., Frierson, G. M., Otto, M. W., Hopkins, L. B., et al. (2016) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000264 · Cited by 103 · see citing works
Income disparity and utilization of cardiovascular preventive care services among U.S. adults
Shahu, A., Okunrintemi, V., Tibuakuu, M., Khan, S. U., Gulati, M., Marvel, F., Blumenthal, R. S., & Michos, E. D. (2021) · American Journal of Preventive Cardiology · doi:10.1016/j.ajpc.2021.100286 · Cited by 44 · see citing works
“[8] Kanjilal S , Gregg EW , Cheng YJ , et al.”
BackgroundCounting dementia: There is no one “best” way
Launer, L. J. (2011) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2010.11.003 · Cited by 33 · see citing works
“instance, risk factors such as smoking and hypertension have decreased [21], but obesity [22] and diabetes [23] are projected to increase over time, and in younger individuals.”
BackgroundKelly, J. M., Jakubovski, E., & Bloch, M. H. (2015) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.13m08922 · Cited by 25 · see citing works
Bashinskaya, B., Nahed, B. V., Walcott, B. P., Coumans, J.-V. C. E., & Onuma, O. K. (2012) · PLoS ONE · doi:10.1371/journal.pone.0046314 · Cited by 27 · see citing works
Huen, K. H., Chowdhury, R., Shafii, S. M., Brewster, L. P., Arya, S., Duwayri, Y., Veeraswamy, R. K., Dodson, T. F., & Rajani, R. R. (2015) · Annals of Vascular Surgery · doi:10.1016/j.avsg.2014.09.014 · Cited by 20 · see citing works
Krishnaswami, J., Jaini, P. A., Howard, R., & Ghaddar, S. (2018) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2018.04.012 · Cited by 20 · see citing works
Effects of Prenatal Poverty on Infant Health: State Earned Income Tax Credits and Birth Weight
Strully, K. W., Rehkopf, D. H., & Xuan, Z. (2010) · American Sociological Review · doi:10.1177/0003122410374086 · Cited by 255 · see citing works
- Authors
- Kanjilal, S.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Corresponding author
- Kanjilal, Sanjat
- ORCID
- Kanjilal, Sanjat
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2006-11-27
- Volume
- 166
- Issue
- 21
- Pages
- 2348
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W2037204010
- Cited by
- 509
- References
- 3
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 18 · 2023: 21 · 2022: 28 · 2021: 13 · 2020: 20 · 2019: 23 · 2018: 24 · 2017: 30 · 2016: 30 · 2015: 36 · 2014: 35 · 2013: 36 · 2012: 32
- FWCI
- 24.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- cardiovascular risk factors, socioeconomic disparities, income, educational attainment, hypercholesterolemia, hypertension, smoking, diabetes mellitus, temporal trends, health disparities, United States adults, prevalence decline, low-income populations, racial disparities, ethnic disparities, diabetes prevalence, hypertension control
- MeSH terms
- Adult, Aged, Cardiovascular Diseases, Cross-Sectional Studies, Diabetes Mellitus, Educational Status, Female, Humans, Hypercholesterolemia, Hypertension, Income, Male, Middle Aged, Risk Factors, Smoking, Social Class, United States, Prevalence
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