Abstract MP63: Cardiovascular Health and Cumulative Burden of Disease in a Rural Adult Population
BACKGROUND: Cardiovascular disease, the leading cause of death in the U.S, is associated with significant socioeconomic and geographic disparities. These disparities may create challenges with individual- or population-based strategies aimed at improving cardiovascular health, particularly if poor cardiovascular health is only one health challenge facing a community. OBJECTIVE: The objective of the current study was to assess the extent to which cardiovascular health, or the absence there of, was accompanied by one or several other health challenges, and the socioeconomic factors associated with disparities in these associations, in a cohort of rural adults. METHODS: We used the comprehensive cardiovascular health index (CVHI) developed by the American Heart Association, which incorporates behavioral and biological factors. We used data from the C8 Health Project to perform a secondary data analysis consisting of a final sample of 51,652 adults (≥20 years old) after exclusions and incomplete data. The CVHI as developed by the AHA was adapted to fit the data and questions available in this cohort. Most notably, dietary quality was excluded and so the final score has a denominator of 6 (vs. 7 as originally published by the AHA). As part of their participation in this project, enrollees completed an extensive health survey that included self-reported medical conditions, several of which were verified with medical records review. RESULTS: Overall, only 9.6% of adults had ideal cardiovascular health (67.4% had intermediate CVHI and 23.1% had poor CVHI). Poor CVHI was associated with increased risk for host of other health problems including: Alzheimer’s, asthma, chronic bronchitis, COPD, emphysema, fibromyalgia, liver disease, arthritis, Parkinson’s, thyroid disease, stroke, kidney disease, and cancer (p<0.05 for all). Multiple age- and gender based disparities were observed. For example, women with poor CVHI were more than twice as likely as men with poor CVHI to also have asthma, chronic bronchitis, immune disease, arthritis, and thyroid disease (p<0.05). Men and women with poor CVHI had similar probability of developing liver disease, stroke and cancer. Older age groups, regardless of gender, were associated with decreasing CVHI. The probability of having multiple diagnoses increased with decreasing CVHI (p<0.05); these differences were not equal across gender and other socioeconomic variables, thus representing sources of health disparities. CONCLUSIONS: Results from this study suggest that CVHI is strongly associated with multiple other health conditions and that these indices of poor health are clustering in lower socioeconomic strata. This clustering and concentration of poor health will likely represent significant challenges for public health advocates developing population-based strategies to improve health.
Author Disclosures: S.J. Frisbee: None. S. Steiner: None. C. Pilkerton: None. S. Singh: None. A. Christian: None. T.K. Bias: None.
- © 2015 by American Heart Association, Inc.