title: Women's prehospital delay associated with myocardial infarction: does race really matter?
abstract: BACKGROUND/RESEARCH OBJECTIVE: Well-documented disparities in cardiovascular health account for approximately one third of the difference in life expectancy between blacks and whites. Mortality from cardiovascular disease is greater among black women than among white women, and black women report longer delays in treatment seeking following onset of symptoms of acute myocardial infarction (AMI). Despite this disparate burden, there is little race-specific data on correlates of delay for black or white women. This secondary data analysis compares duration and correlates of delay in treatment seeking by race following onset of AMI symptoms.
  
  
  METHODS
  We analyzed self-report data from 509 black and 500 white women, interviewed 4 to 6 months after AMI, using multivariable logistic and linear regression.
  
  
  CONCLUSIONS
  Median delay time was nonsignificantly shorter for black than for white women (1.0 vs 1.5 hours). Equal proportions of black and white women (57% vs 54%) sought treatment within 2 hours of symptom onset. In multivariable analyses, correct attribution of symptoms to AMI was a significant predictor of treatment seeking within 2 hours of symptom onset for black and white women (odds ratios = 2.79 and 3.86, respectively); eligibility for public insurance was a significant predictor for black women only (odds ratio = 2.3). Common comorbidities, AMI risk factors, and other demographics were not significantly associated with delay time. Insurance coverage and the correct attribution of symptoms to cardiac causes are substantial and modifiable predictors of delay in seeking treatment of AMI.
authors.affiliation: College of Nursing, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA. jcmcsweeney@uams.edu
authors.forename: Jean C
authors.initials: JC
authors.lastname: McSweeney
authors.forename: Leanne L
authors.initials: LL
authors.lastname: Lefler
authors.forename: Ellen P
authors.initials: EP
authors.lastname: Fischer
authors.forename: Albert Joe
authors.initials: AJ
authors.lastname: Naylor
authors.forename: Laura K
authors.initials: LK
authors.lastname: Evans
mesh_terms: D001741:Black or African American / Q000523:psychology*; D015897:Comorbidity; D044962:Data Compression; D005260:Female; D006801:Humans; D008017:Life Expectancy; D016015:Logistic Models; D009203:Myocardial Infarction / Q000523:psychology* / Q000628:therapy; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012307:Risk Factors; D012923:Social Class; D013997:Time Factors; D044465:White People