Racial and ethnic disparity in blood pressure and cholesterol measurement.
OBJECTIVE
To evaluate racial and ethnic disparity in blood pressure and cholesterol measurement and to analyze factors associated with any observed disparity.


METHODS
Cross-sectional analysis of the household component of the 1996 Medical Expenditure Panel Survey.


METHODS
Representative sample of the U.S. non-institutionalized population age 21 or older.


METHODS
Prevalence of self-reported blood pressure measurement within 2 years and cholesterol measurement within 5 years were calculated by race/ethnicity. Logistic regression was used to adjust for health insurance status, having a usual source of care, health status, and socioeconomic and demographic factors. Odds ratios and 95% confidence intervals (95% CIs) from the logistic regression were converted to prevalence ratios to estimate relative risk (RR).


RESULTS
Mexican Americans compared to non-Hispanic whites were less likely to have a blood pressure measurement (RR, 0.85; 95% CI, 0.81 to 0.89) or a cholesterol measurement (RR, 0.72; 95% CI, 0.65 to 0.78). Non-Hispanic blacks had blood pressure and cholesterol measurements similar to non-Hispanic whites. In a multivariate analysis, Mexican Americans had similar blood pressure measurements (RR, 0.97; 95% CI, 0.94 to 1.00) and cholesterol measurements (RR, 1.04; 95% CI, 0.99 to 1.08). The factors associated with the largest disparity were lack of health insurance, not having a usual source of care, and low education.


CONCLUSIONS
No disparity was found between non-Hispanic blacks and non-Hispanic whites in undergoing blood pressure and cholesterol measurement. Disparities in cardiovascular preventive services for Mexican Americans were associated with lack of health insurance and a usual source of care, but other demographic and socioeconomic factors were also important.
Stewart
Scott H
SH
Division of General Internal Medicine and the Center for Health Care Research, Medical University of South Carolina, Charleston, SC, USA. Sstewart@ams.ecmc.edu
Silverstein
Marc D
MD
D000328:Adult; D000368:Aged; D001795:Blood Pressure Determination / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D006937:Hypercholesterolemia / Q000175:diagnosis* / Q000208:ethnology*; D006973:Hypertension / Q000175:diagnosis* / Q000208:ethnology*; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012044:Regression Analysis; D012959:Socioeconomic Factors