Social and psychosocial determinants of racial and ethnic differences in cardiovascular health: The MASALA and MESA studies

Nilay S. Shah, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
Xiaoning Huang, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
Lucia C. Petito, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
Michael P. Bancks, Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, United States.
Alka M. Kanaya, Department of Medicine, University of California San Francisco, San Francisco, CA, United States.
Sameera Talegawkar, George Washington University School of Public Health, Washington, DC, United States.
Saaniya Farhan, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
Mercedes R. Carnethon, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
Donald M. Lloyd-Jones, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
Norrina B. Allen, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
Namratha R. Kandula, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
Sadiya S. Khan, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.

Document Type

Journal Article

Publication Date

3-1-2024

Journal

American journal of preventive cardiology

Volume

17

DOI

10.1016/j.ajpc.2024.100636

Keywords

Cardiovascular health; Epidemiology; Psychosocial health; Racial disparities; Social determinants of health

Abstract

BACKGROUND: Social and psychosocial determinants are associated with cardiovascular health (CVH). OBJECTIVES: To quantify the contributions of social and psychosocial factors to racial/ethnic differences in CVH. METHODS: In the Multi-Ethnic Study of Atherosclerosis and Mediators of Atherosclerosis in South Asians Living in America cohorts, Kitagawa-Blinder-Oaxaca decomposition quantified the contributions of social and psychosocial factors to differences in mean CVH score (range 0-14) in Black, Chinese, Hispanic, or South Asian compared with White participants. RESULTS: Among 7,978 adults (mean age 61 [SD 10] years, 52 % female), there were 1,892 Black (mean CVH score for decomposition analysis 7.96 [SD 2.1]), 804 Chinese (CVH 9.69 [1.8]), 1,496 Hispanic (CVH 8.00 [2.1]), 1,164 South Asian (CVH 9.16 [2.0]), and 2,622 White (CVH 8.91 [2.1]) participants. The factors that were associated with the largest magnitude of explained differences in mean CVH score were income for Black participants (if mean income in Black participants were equal to White participants, Black participants' mean CVH score would be 0.14 [SE 0.05] points higher); place of birth for Chinese participants (if proportion of US-born and foreign-born individuals among Chinese adults were equivalent to White participants, Chinese participants' mean CVH score would be 0.22 [0.10] points lower); and education for Hispanic and South Asian participants (if educational attainment were equivalent to White participants, Hispanic and South Asian participants' mean CVH score would be 0.55 [0.11] points higher and 0.37 [0.11] points lower, respectively). CONCLUSIONS: In these multiethnic US cohorts, social and psychosocial factors were associated with racial/ethnic differences in CVH.

Department

Exercise and Nutrition Sciences

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