Chest pain admissions: characteristics of black, Latino, and white patients in low- and mid-socioeconomic strata.
To assess the potential impact of socioeconomic status (SES) factors on health-care seeking behavior for suspected acute coronary artery disease symptoms, equal numbers of black, Latino, and white patients seeking care for chest pain at two large hospital emergency rooms were studied. Differences between low and middle SES groups with respect to pre-attack health, health history, ethnicity, gender, and modes of transportation to the hospital were explored. Highly significant self-reported differences between low SES and middle SES patients were found as follows: low SES subjects were more likely to describe themselves as being in fair to poor general health (68% versus 18%), had more frequent chest pain, reported other types of heart disease, were more often current smokers, more likely to be black or Latino, and to be younger. Members of the low SES group also were less [corrected] likely to have known cholesterol levels, to have used estrogen, to have had a prior ECG or cardiac surgery, to be nonsmokers, to have had a stress test, and to have typical angina. Middle SES subjects more often described typical angina, prior use of estrogen (females), congenital, rheumatic, or family history of heart disease, prior knowledge of high cholesterol, were more likely to be of the male gender, and to be older than the low SES cohort. The data reveal that low SES subjects, with markedly less health-care resources compared with middle SES subjects, have a worse general health and cardiac risk profile despite the fact that they were significantly younger (mean age 53.4 versus 60.7, P < .001).(ABSTRACT TRUNCATED AT 250 WORDS)
Haywood
L J
LJ
USC School of Medicine, Los Angeles.
Ell
K
K
deGuman
M
M
Norris
S
S
Blumfield
D
D
Sobel
E
E
D001741:Black or African American / Q000706:statistics & numerical data; D002637:Chest Pain / Q000453:epidemiology*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data*; D012307:Risk Factors; D012959:Socioeconomic Factors; D044465:White People / Q000706:statistics & numerical data