State of disparities in cardiovascular health in the United States.
BACKGROUND
Reducing health disparities remains a major public health challenge in the United States. Having timely access to current data on disparities is important for policy and program development. Accordingly, we assessed the current magnitude of disparities in cardiovascular disease (CVD) and its risk factors in the United States.


RESULTS
Using national surveys, we determined CVD and risk factor prevalence and indexes of morbidity, mortality, and overall quality of life in adults > or =18 years of age by race/ethnicity, sex, education level, socioeconomic status, and geographic location. Disparities were common in all risk factors examined. In men, the highest prevalence of obesity (29.2%) was found in Mexican Americans who had completed a high school education. Black women with or without a high school education had a high prevalence of obesity (47.3%). Hypertension prevalence was high among blacks (39.8%) regardless of sex or educational status. Hypercholesterolemia was high among white and Mexican American men and white women in both groups of educational status. Ischemic heart disease and stroke were inversely related to education, income, and poverty status. Hospitalization was greater in men for total heart disease and acute myocardial infarction but greater in women for congestive heart failure and stroke. Among Medicare enrollees, congestive heart failure hospitalization was higher in blacks, Hispanics, and American Indians/Alaska Natives than among whites, and stroke hospitalization was highest in blacks. Hospitalizations for congestive heart failure and stroke were highest in the southeastern United States. Life expectancy remains higher in women than men and higher in whites than blacks by approximately 5 years. CVD mortality at all ages tended to be highest in blacks.


CONCLUSIONS
Disparities in CVD and related risk factors remain pervasive. The data presented here can be invaluable for policy development and in the planning, implementation, and evaluation of interventions designed to eliminate health disparities.
Mensah
George A
GA
Office of the Director, Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control, Mail Stop K-40, 4770 Buford Hwy NE, Atlanta, GA 30341-3717, USA. ghm8@cdc.gov
Mokdad
Ali H
AH
Ford
Earl S
ES
Greenlund
Kurt J
KJ
Croft
Janet B
JB
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000706:statistics & numerical data; D001798:Blood Proteins / Q000032:analysis; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000208:ethnology; D015897:Comorbidity; D004522:Educational Status; D005260:Female; D006306:Health Surveys; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006937:Hypercholesterolemia / Q000208:ethnology; D006973:Hypertension / Q000208:ethnology; D007182:Income; D007198:Indians, North American / Q000706:statistics & numerical data; D008017:Life Expectancy; D008019:Life Style; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data; D008875:Middle Aged; D009765:Obesity / Q000208:ethnology; D011203:Poverty; D011788:Quality of Life; D012307:Risk Factors; D012309:Risk-Taking; D012737:Sex Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013689:Telephone; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
D001798:Blood Proteins