Abstract P374: Psychosocial and Contextual Predictors of Cardiovascular Health: Findings from the Survey of the Health of Wisconsin
In 2010, the American Heart Association identified seven risk factors and health behaviors (body mass index, cholesterol, glucose, diet, physical activity, blood pressure and smoking) that can be combined to indicate “ideal,” “intermediate,” or “poor” cardiovascular health (CVH). Previous studies have demonstrated that CVH predicts cardiovascular disease incidence. The goals of this study are 1) to estimate the population prevalence of “good” CVH (defined as having an ideal or intermediate CVH score) and distribution of CVH indicators in a statewide examination survey in Wisconsin; and 2) to examine the socioeconomic, psychosocial and social/build environment correlates of CVH and its components.
We used data from the Survey of the Health of Wisconsin (SHOW) a geographically diverse (urban and rural) population-based research study of adults, age 21-74 years (n=2,479), to estimate the prevalence and correlates of CVH status between 2008-2011. In addition to markers of socioeconomic status, psychosocial determinants examined included self-reported health and measures of mental wellbeing (using the Depression, Anxiety and Stress Scale, DASS), perceptions of discrimination and neighborhood environment, and access to health care. Contextual predictors included county and census-block group (CBG) socioeconomic indicators_summarized by an “economic hardship index” (EHI) score, and objective measures of the built environment.
Of the 2,479 participants, 1,643 had complete data. Of these, only 1.0% had ideal CVH (“ideal” in all 7 metrics) and 74.4% had “poor” CVH (at least one “poor” of the 7 components). The prevalence of good CVH was higher in younger, white, higher education and income participants, and those living in suburban, compared to rural and urban areas. Good CVH was less frequent in those with depression, anxiety, self-perceived discrimination, those reporting frequent use of fast food restaurants, those in Medicaid, and those lacking health insurance. In age-gender-race adjusted analyses, the adjusted prevalence of good CVH with increasing tertiles of CBG EHI was 31%, 27%, and 19%, respectively (p for trend=0.0002). Among the 7 CVH indicators, EHI was most strongly associated with smoking and diet. Objective CBG/county measures of built environment conducive for physical activity, social connectedness, and access to primary health care were associated with higher prevalence of good CVH.
In conclusion, population prevalence of ideal CVH in this population-based sample is low. Our findings on the psychosocial and contextual correlates of CVH provide clues regarding the profile of individuals and subgroups where interventions to improve CVH are most needed.
- © 2013 by American Heart Association, Inc.