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Cardiovascular Outcomes, Health-Promoting Behaviors, and Social Determinants: Structural Racism and the Behavioral
Jaclyn K Schwartz1, Emily A Kringle2, Suzanne Perea Burns3
1Program in Occupational Therapy, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA.
Insights
Historically marginalized groups face higher cardiovascular disease rates despite similar health behaviors. Structural factors like racism likely drive these health disparities, necessitating equity-focused research.
Area of Science:
- Public Health
- Health Disparities Research
- Cardiovascular Epidemiology
Background:
- Cardiovascular disease (CVD) disproportionately impacts marginalized populations in the U.S.
- Understanding disparities in CVD outcomes, social determinants, and behaviors across racial/ethnic groups is crucial.
Purpose of the Study:
- To explore disparities in cardiovascular health outcomes, social determinants of health, and health-promoting behaviors across racial and ethnic groups.
- To identify patterns of CVD and diabetes prevalence, healthcare access barriers, and health behaviors among diverse populations.
Main Methods:
- Descriptive analysis of the 2019 Behavioral Risk Factor Surveillance System (BRFSS) data.
- Examination of cardiovascular conditions, diabetes, social determinants of health, and health-promoting behaviors.
- Stratification of analysis across eight racial/ethnic categories.
Main Results:
- Historically marginalized groups exhibit higher CVD rates and healthcare access barriers.
- These groups often engage in equal or higher rates of health-promoting behaviors compared to White adults.
- Black adults showed the highest hypertension prevalence (41%) alongside the highest blood pressure management behaviors.
Conclusions:
- Health disparities persist despite comparable health-promoting behaviors, indicating the significant role of structural factors like racism.
- Quantitative Critical Theory suggests potential biases in measurement tools and data categorization perpetuate inequities.
- Equity-focused research addressing structural racism, using culturally relevant measures and involving marginalized communities, is essential for advancing cardiovascular health equity.
Purpose:
Cardiovascular disease disproportionately affects historically marginalized populations in the United States. This study explored disparities in cardiovascular health outcomes, social determinants of health, and health-promoting behaviors across racial and ethnic groups.
Methods:
Using data from the 2019 Behavioral Risk Factor Surveillance System, we conducted a descriptive analysis of cardiovascular conditions and diabetes, social determinants of health, and health-promoting behaviors across eight racial/ethnic categories.
Results:
Historically marginalized groups had higher rates of cardiovascular conditions and greater barriers to health care access. However, these groups often demonstrated equal or higher rates of engagement in health-promoting behaviors compared with White adults. For example, Black adults had the highest hypertension prevalence (41%) despite having the highest rates of blood pressure management behaviors.
Discussion:
The persistence of health disparities despite equivalent health-promoting behaviors suggests a significant influence of structural factors like racism. Critical examination using Quantitative Critical Theory revealed potential biases in measurement tools and data categorization that may perpetuate inequities.
Health Equity Implications:
Findings underscore the need for equity-focused research approaches that explicitly address structural racism. Future studies should prioritize culturally relevant measures, clinically meaningful outcomes, and active involvement of researchers from marginalized communities to advance cardiovascular health equity.
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