Women's prehospital delay associated with myocardial infarction: does race really matter?
Jean C McSweeney1, Leanne L Lefler, Ellen P Fischer
1College of Nursing, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA. jcmcsweeney@uams.edu
Insights
Black and white women experienced similar delays in seeking treatment for acute myocardial infarction (AMI). Correctly identifying AMI symptoms and having public insurance significantly predicted faster treatment seeking in women.
Area of Science:
- Cardiology
- Public Health
- Health Disparities
Background:
- Cardiovascular disease (CVD) disparities contribute significantly to reduced life expectancy in Black individuals.
- Black women experience higher CVD mortality and report longer delays in seeking treatment for acute myocardial infarction (AMI) compared to white women.
- Limited race-specific data exists on factors influencing treatment delays for AMI in women.
Purpose of the Study:
- To compare the duration and correlates of delayed treatment seeking following AMI symptom onset between Black and white women.
- To identify modifiable factors that influence timely medical attention for AMI in diverse female populations.
Main Methods:
- Secondary data analysis of self-report data from 509 Black and 500 white women interviewed 4-6 months post-AMI.
- Multivariable logistic and linear regression models were employed to analyze treatment delay duration and predictors.
Main Results:
- Median delay time was similar between Black (1.0 hours) and white women (1.5 hours), with no statistically significant difference.
- Similar proportions of Black (57%) and white (54%) women sought treatment within 2 hours of symptom onset.
- Correctly attributing symptoms to AMI (ORs=2.79-3.86) and public insurance eligibility (OR=2.3 for Black women) were significant predictors of timely treatment seeking.
Conclusions:
- Correct symptom attribution and public insurance coverage are significant, modifiable predictors of seeking timely treatment for AMI.
- Demographics, comorbidities, and AMI risk factors were not significantly associated with treatment delay.
- Interventions should focus on improving symptom recognition and addressing insurance-related barriers to reduce AMI treatment delays in women.
Unlabelled:
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.
Subjects/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.
Results/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.
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