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Prevalence and social correlates of cardiovascular disease risk factors in Harlem
A V Diez-Roux1, M E Northridge, A Morabia
1Division of General Medicine, Columbia College of Physicians and Surgeons, USA. diezrou@medicine1.cpmc.columbia.edu
Insights
Cardiovascular disease risk factors are common in disadvantaged urban communities. Socioenvironmental factors like low income and education significantly increase the risk of multiple risk factors.
Area of Science:
- Public Health
- Epidemiology
- Social Medicine
Background:
- Cardiovascular disease (CVD) poses a significant health burden, particularly in underserved urban populations.
- Understanding the prevalence and social correlates of CVD risk factors is crucial for targeted interventions.
Purpose of the Study:
- To investigate the prevalence, social correlates, and clustering of CVD risk factors.
- To examine these factors within a predominantly Black, poor, urban community in Central Harlem.
Main Methods:
- A population-based sample of 695 men and women (aged 18-65) was surveyed.
- Prevalence of hypertension, smoking, overweight, and physical inactivity was assessed.
- Associations with sociodemographic variables, income, education, and socioenvironmental factors were analyzed.
Main Results:
- High prevalence of hypertension (1/3), smoking (men 48%, women 41%), overweight (men 25%, women 49%), and physical inactivity (men 23%, women 35%).
- Over 80% had at least one risk factor; 9% of men and 19% of women had three or more.
- Low income and education were strongly associated with hypertension, smoking, inactivity, and multiple risk factors (ORs up to 10.2).
Conclusions:
- Disadvantaged urban communities face elevated CVD risk.
- Socioenvironmental factors are critical determinants of cardiovascular risk profiles in these populations.
Objectives:
This study examined the prevalence, social correlates, and clustering of cardiovascular disease risk factors in a predominantly Black, poor, urban community.
Methods:
Associations of risk factor prevalences with sociodemographic variables were examined in a population-based sample of 695 men and women aged 18 to 65 years living in Central Harlem.
Results:
One third of the men and women were hypertensive, 48% of the men and 41% of the women were smokers, 25% of the men and 49% of the women were overweight, and 23% of the men and 35% of the women reported no leisure-time physical activity over the past month. More than 80% of the men and women had at least 1 of these risk factors, and 9% of the men and 19% of the women had 3 or more risk factors. Income and education were inversely related to hypertension, smoking, and physical inactivity. Having 3 or more risk factors was associated with low income and low education (extreme odds ratio [OR] = 10.2, 95% confidence interval [CI] = 3.0, 34.5 for education; OR = 3.7, CI = 1.6, 8.9 for income) and with a history of unstable work or of homelessness.
Conclusions:
Disadvantaged, urban communities are at high risk for cardiovascular disease. These results highlight the importance of socioenvironmental factors in shaping cardiovascular risk.