The effects of socioeconomic status, medical care access and cost on the prevalence of hypertension and cholesterol in the adult population of Virginia
EDINA FAZLIC
Advisor: Shelley A. Harris, Ph.D., M.SC.
Preceptor: Gerges Seifen, M.D., MPH.
Objectives: Cardiovascular disease is the leading cause of death in the United States. High blood pressure and high blood cholesterol are the major modifiable risk factors for cardiovascular disease. There are significant disparities in hypertension, high blood cholesterol prevalence and screening rates across age, gender, and racial and socioeconomic groups in the United States. The purpose of this study was to examine the prevalence of hypertension, high blood cholesterol, and screening rates in the Virginia adult population, and to determine the association between socioeconomic correlates, medical care access and cost on hypertension, high cholesterol and screening prevalence.
Methods: Data from 1,996 participants age 18 and older interviewed in the year 2000 Behavior Risk Factor Surveillance System were analyzed. Dependent variables were defined by answering, “Yes”, on a specific question: Have you ever been told by a doctor that you have high blood pressure or high blood cholesterol? Also they were asked about the amount of time that elapsed since they last had their blood pressure or cholesterol checked. Basic descriptive statistics including: frequency distribution, prevalence, odds ratios and corresponding 95% CI were employed by using SPSS and Epi Info software. Logistic regression analysis was used for establishing association and controlling for confounders. V
Results: One fourth of survey participants had. self-reported hypertension and high blood cholesterol. The prevalence of hypertension and high blood cholesterol was inversely related to the socioeconomic status. After controlling for confounding variables, low income was a significant predictor of the risk for self-reported hypertension, with the Adjusted Odds Ratios 2.1, 95% CI 1.13-3.99, and low education was a strong predictor of the risk for self-reported high cholesterol, with the Adjusted Odds Ratios 1.91 95% CI 1.14-3.22. In the past two years 3.4% of survey participants were not screened for high blood pressure, and 11.4% participants were not screened for blood cholesterol. The younger participants, ages 18-3 , with the lowest annual income and without health care coverage were at the highest risk for not being screened for high blood pressure and blood cholesterol in past two years.
Conclusion: Further studies are needed to explain how socioeconomic status promote and reinforce development of cardiovascular risk factors and unhealthy behaviors in disadvantaged population. The prevalence of hypertension and high cholesterol considerably exceeds the objectives of Healthy People 2010, and screening rates are significantly lower than the objectives. The results from this study can be used for policy formulation, target intervention, and could provide baseline values for further evaluation of the progress of preventive measures.
