Identifying Social Determinants of Health and Inequities Between Low- and High-Income Counties When Assessing the Prevalence of Coronary Heart Disease
Document Type
Article
Abstract
Background: The incidences of diabetes, obesity and hypertension have been increasing at alarming rates, and have been known to play a significant role in the development of Coronary Heart Disease (CHD). CHD has been a major cause of mortality and healthcare burden. While we have been able to identify various management and educational guidelines to assist patients with modifiable risk factors; we have not successfully addressed the social determinants of health (SDoH) that are preventing patients from adhering to medication, diets, or exercise regiments.
Methods: This was a retrospective cohort study using data from the USDA and CDC's division of Behavioral Risk Factor Surveillance System. We compared median household income of US counties and other SDoH to the prevalence of diabetes, obesity, hypertension. For data analysis we used SPSS (IBM®).
Results: Once we stratified counties by median household income quartiles(Q) we found a difference in Q1 versus Q4 in percent of diabetes, obesity, hypertension, recreational facilities and spending in fast food restaurants. We looked at n=3142 counties with a median income range $20,577-$119,075. Statistical significance was noted between Q1 vs. Q4 in percent of diabetics: 12.54% vs. 9.07% (p<0.05), respectively. Hypertension: Q1 vs Q4: 37.13% vs. 28.29% (p<0.05). Change in per capita spending in fast food: Q1 = 48.38% and Q4 = 29.13% (p<0.05). Obesity: Q1 = 32.95% and Q4 = 28% (p<0.05) and recreation and exercise facilities in Q1= 0.5 per capita and Q4= 1.1 per capita (p<0.05). Low access to transportation and stores: Q1=4.85% vs Q4=1.92% (p<0.05).
Conclusion: CHD accounts for $89 billion in healthcare spending every year. These costs are predicted to double over the next decade to $154 billion. Identifying key social determinants of health that effect the risk of developing CHD is vital to preventing this economic and health burden. Our results demonstrate that there is an inequity when it comes to social infrastructures and nutrition education between low-income regions and high-income regions.
First Page
1688
Last Page
143
DOI
10.1016/S0735-1097(23)02132-0
Publication Date
3-7-2023
Recommended Citation
Roma N, Yellapu V, Antoine MK, Amaratunga EA, Shah K, Nanda S. IDENTIFYING SOCIAL DETERMINANTS OF HEALTH AND INEQUITIES BETWEEN LOW-AND HIGH-INCOME COUNTIES WHEN ASSESSING THE PREVALENCE OF CORONARY HEART DISEASE. Journal of the American College of Cardiology. 2023 Mar 7;81(8_Supplement):1688-.