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Diferencias raciales y étnicas en la mortalidad por todas las causas y enfermedades cardiovasculares: el estudio MESA
Wendy S Post1,2, Karol E Watson3, Spencer Hansen4
1Division of Cardiology, Department of Medicine (W.S.P., J.A.C.L.), Johns Hopkins University, Baltimore, MD.
Circulation
|July 21, 2022
Resumen
Las disparidades raciales y étnicas en la mortalidad persisten, impulsadas en gran medida por los determinantes sociales de la salud. Abordar los factores sistémicos es crucial para mejorar la equidad en salud en diversas poblaciones.
Área de la Ciencia:
- Salud pública
- Epidemiología
- Determinantes sociales de la salud
Sus antecedentes:
- Las disparidades raciales y étnicas persistentes en la longevidad y la mortalidad por enfermedades cardiovasculares (ECV) existen a pesar de las mejoras en la salud de la población.
- El estudio multiétnico de la aterosclerosis (MESA) investigó estas disparidades.
Objetivo del estudio:
- Describir los riesgos de mortalidad por todas las causas y enfermedades cardiovasculares por raza y etnia.
- Examinar la influencia del estatus socioeconómico (SES) y otros factores en estas disparidades.
Principales métodos:
- Utilizó el modelo de riesgos proporcionales de Cox con covariables actualizadas en el tiempo en 6814 adultos estadounidenses (de 45 a 84 años) del estudio MESA.
- Ajustado progresivamente por edad, sexo, SES, estilo de vida, factores psicosociales y de riesgo clínico y antecedentes de inmigración.
- Las asociaciones evaluadas entre la raza / etnia autoinformada y la mortalidad por cualquier causa / ECV durante una mediana de 15,8 años.
Principales resultados:
- Inicialmente, los participantes negros tenían una mortalidad más alta (HR 1.34), los chinos más baja (HR 0.79), y los hispanos sin diferencia frente a los participantes blancos.
- Después del ajuste de SES, la mortalidad negra HR disminuyó (HR 1.16) pero se mantuvo significativa; los riesgos de mortalidad chinos e hispanos también disminuyeron.
- Los ajustes adicionales para otros factores eliminaron diferencias significativas de mortalidad para los participantes negros y chinos en comparación con los blancos, y mostraron un menor riesgo para los participantes hispanos (HR 0.77).
Conclusiones:
- Las diferencias raciales y étnicas en la mortalidad son en gran medida atribuibles a los determinantes sociales de la salud.
- Los resultados subrayan la necesidad de identificar y abordar los factores sistémicos que contribuyen a las disparidades en materia de salud.
- Las intervenciones deben centrarse en los factores sociales y sistémicos para promover la equidad en materia de salud.
Palabras clave:
Enfermedades cardiovasculareslas minorías étnicas y racialesDiferencias en el estado de saludDeterminantes sociales de la saludMás Videos Relacionados
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