Background:
Socioeconomic status (SES) has been shown to be associated with many cardiovascular (CV) risk factors. Prior studies have identified differences by SES, but have not summarized trends in these disparities across multiple SES subgroups, which could allow us to assess the extent to which we are achieving disparity-related goals.
Methods:
We used NHANES Surveys from cycles 1999–2000, 2001–2002, 2003–2004, and 2005–2006 to examine the age-adjusted prevalence of ideal levels of CV health components by SES. Ideal levels of BMI, cholesterol, glucose, blood pressure, diet, physical activity and smoking were defined according to the AHA 2020 strategic goals. SES was defined by poverty: income ratio and categorized as <1.00, 1.00-2.99, and 3.00+. Both absolute (Absolute Concentration Index- ACI) and relative measures (Relative Concentration Index -RCI) of disparities were calculated, all calculations were weighted by population share. The percentage change in disparities relative to 1999–2000 was examined.
Results:
Age-adjusted rates of ideal CV health components and the percentage change from 1999–2006 varied by SES (see Table). Among women, disparities in the prevalence rates of ideal levels of CV risk factors have increased between SES groups from 1999 through 2006. Among men, disparities in blood pressure (ACI=503%, RCI=477%) and diet (ACI=405%, RCI=143%) have increased most dramatically. More moderate increases were seen in disparities in smoking and cholesterol for men. Disparities in BMI and physical activity remained relatively constant among men throughout the study period. Findings were generally similar for both absolute and relative measures of disparities.
Conclusions:
Representative national data on these summary measures of disparities suggest that disparities between SES groups have increased among men. Understanding the issues underlying these increasing disparities and addressing them will be critical to improving the cardiovascular health of all Americans by 2020 and beyond.