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Disparities in Statin Use in New York City: Implications for Health Reform
Catherine Allende1, Michael K Gusmano2, Daniel Weisz3
1Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
Insights
Low income, depression, and reliance on emergency care are linked to poor adherence to cholesterol medication. These findings highlight disparities in cardiovascular disease management for vulnerable populations.
Area of Science:
- Public Health
- Cardiology
- Health Disparities
Background:
- Heart disease is a leading cause of mortality in the USA.
- Cholesterol-lowering medications reduce cardiovascular disease risk but adherence is a challenge.
- Existing literature highlights disparities in heart disease treatment.
Purpose of the Study:
- To investigate factors influencing non-adherence to cholesterol-lowering medication regimens.
- To identify patient subgroups with lower adherence rates.
- To examine disparities in medication compliance among adults aged 45+ with diagnosed high cholesterol.
Main Methods:
- Analysis of data from the 2014 New York City Community Health Survey.
- Focus on adults aged 45 and older with diagnosed elevated cholesterol.
- Inclusion of individuals advised by a health professional to take cholesterol-lowering medication.
Main Results:
- Individuals with low incomes, those using emergency departments, lacking recent medical care, experiencing depression, and identifying as Black non-Hispanic or Hispanic showed lower adherence.
- Medicare beneficiaries were less likely to adhere compared to those with private insurance.
- Medicaid beneficiaries and uninsured individuals did not exhibit lower adherence rates.
Conclusions:
- Significant disparities exist in adherence to cholesterol-lowering medication.
- Socioeconomic status, healthcare access, mental health, and race/ethnicity are critical factors influencing medication compliance.
- Targeted interventions are needed to improve adherence among vulnerable patient groups.
Abstract:
Heart disease is the leading cause of death in the USA, and there is an extensive literature describing disparities in the treatment of the disease. Cholesterol-lowering medications are an effective strategy for reducing the risk of cardiovascular diseases for many patients, but some who are prescribed these medications fail to take them. We examine data from the 2014 New York City Community Health Survey to investigate the factors that influence why patients are not compliant in following the prescribed regimen. We focus on adults age 45 and older who report that they are diagnosed with elevated cholesterol levels and were told by a health professional they needed to take cholesterol-lowering medication. We find that evident disparities: individuals with low incomes, those who rely on emergency departments for their healthcare, have not received medical care within the past year, are depressed, and identify as black non-Hispanic and Hispanic are less likely to adhere to a cholesterol-lowering medication program. Although Medicare beneficiaries are less likely to take cholesterol-lowering medication than those with private insurance, those who were on Medicaid or were uninsured did not report lower rates of adherence.
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