Cardiovascular health: associations with race–ethnicity, nativity, and education in a diverse, population-based sample of Californians

• Published in: Annals of epidemiology Vol. 23; no. 7; pp. 388 - 394
• Main Authors: Bostean, Georgiana, PhD, Roberts, Christian K., PhD, Crespi, Catherine M., PhD, Prelip, Michael, DPA, MPH, Peters, Anne, MD, Belin, Thomas R., PhD, McCarthy, William J., PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2013
• Subjects: Adult; Aged; California - epidemiology; Cardiovascular Diseases - ethnology; Educational Status; Emigrants and Immigrants - statistics & numerical data; Ethnicity - statistics & numerical data; Female; Health behavior; Health Status; Health Surveys; Humans; Immigrants; Internal Medicine; Lifestyle; Male; Middle Aged; Obesity - ethnology; Population Surveillance; Prevalence; Racial Groups - statistics & numerical data; Risk factors; Socioeconomic Factors; California; Lifestyle; Immigrants; Risk factors; Health behavior
• ISSN: 1047-2797; 1873-2585
• DOI: 10.1016/j.annepidem.2013.04.012

Abstract Purpose This study examined how race–ethnicity, nativity, and education interact to influence disparities in cardiovascular (CV) health, a new concept defined by the American Heart Association. We assessed whether race–ethnicity and nativity disparities in CV health vary by education and whether the foreign-born differ in CV health from their U.S.-born race–ethnic counterparts with comparable education. Methods We used data from the 2009 California Health Interview Survey to determine the prevalence of optimal CV health metrics (based on selected American Heart Association guidelines) among adults ages 25 and older (n = 42,014). We examined the interaction between education and ethnicity–nativity, comparing predicted probabilities of each CV health measure between U.S.-born and foreign-born White, Asian, and Latino respondents. Results All groups were at high risk of suboptimal physical activity levels, fruit and vegetable and fast food consumption, and overweight/obesity. Those with greater education were generally better off except among Asian respondents. Ethnicity–nativity differences were more pronounced among those with less than a college degree. The foreign-born respondents exhibited both advantages and disadvantages in CV health compared with their U.S.-born counterparts that varied by ethnicity–nativity. Conclusions Education influences ethnicity–nativity disparities in CV health, with most race–ethnic and nativity differences occurring among the less educated. Studies of nativity differences in CV health should stratify by education in order to adequately address SES differences.