Educational Attainment, Race, and Ethnicity as Predictors for Ideal Cardiovascular Health: From the National Health and Nutrition Examination Survey
Background Educational attainment is protective for cardiovascular health (CVH), but the benefits of education may not persist across racial and ethnic groups. Our objective was to determine whether the association between educational attainment and ideal CVH differs by race and ethnicity in a natio...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.121.023438 |
| _version_ | 1798020144097656832 |
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| author | Amber E. Johnson Brandon M. Herbert Natalie Stokes Maria M. Brooks Belinda L. Needham Jared W. Magnani |
| author_facet | Amber E. Johnson Brandon M. Herbert Natalie Stokes Maria M. Brooks Belinda L. Needham Jared W. Magnani |
| author_sort | Amber E. Johnson |
| collection | DOAJ |
| description | Background Educational attainment is protective for cardiovascular health (CVH), but the benefits of education may not persist across racial and ethnic groups. Our objective was to determine whether the association between educational attainment and ideal CVH differs by race and ethnicity in a nationally representative sample. Methods and Results Using the National Health and Nutrition Examination Survey, we determined the distribution of ideal CVH, measured by Life’s Simple 7, across levels of educational attainment. We used multivariable ordinal logistic regression to assess the association between educational attainment (less than high school, high school graduate, some college, college graduate) and Life’s Simple 7 category (ideal, intermediate, poor), by race and ethnicity (Asian, Black, Hispanic, White). Covariates were age, sex, history of cardiovascular disease, health insurance, access to health care, and income–poverty ratio. Of 7771 National Health and Nutrition Examination Survey participants with complete data, as level of educational attainment increased, the criteria for ideal health were more often met for most metrics. After adjustment for covariates, effect of education was attenuated but remained significant (P<0.01). Those with at least a college degree had 4.12 times the odds of having an ideal Life’s Simple 7 compared with less than high school (95% CI, 2.70–5.08). Among all racial and ethnic groups, as level of educational attainment increased, so did Life’s Simple 7. The magnitude of the association between education and CVH varied by race and ethnicity (interaction P<0.01). Conclusions Our findings demonstrate that educational attainment has distinct associations with ideal CVH that differs by race and ethnicity. This work demonstrates the need to elucidate barriers preventing individuals from racial and ethnic minority groups from achieving equitable CVH. |
| first_indexed | 2024-04-11T16:52:53Z |
| format | Article |
| id | doaj.art-15a55645ff3043499209964b695fcefe |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-11T16:52:53Z |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-15a55645ff3043499209964b695fcefe2022-12-22T04:13:21ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-01-0111210.1161/JAHA.121.023438Educational Attainment, Race, and Ethnicity as Predictors for Ideal Cardiovascular Health: From the National Health and Nutrition Examination SurveyAmber E. Johnson0Brandon M. Herbert1Natalie Stokes2Maria M. Brooks3Belinda L. Needham4Jared W. Magnani5Division of Cardiology University of Pittsburgh School of Medicine Pittsburgh PADepartment of Epidemiology Graduate School of Public Health University of Pittsburgh PADivision of Cardiology University of Pittsburgh School of Medicine Pittsburgh PADepartment of Epidemiology Graduate School of Public Health University of Pittsburgh PAUniversity of Michigan School of Public Health Ann Arbor MIDivision of Cardiology University of Pittsburgh School of Medicine Pittsburgh PABackground Educational attainment is protective for cardiovascular health (CVH), but the benefits of education may not persist across racial and ethnic groups. Our objective was to determine whether the association between educational attainment and ideal CVH differs by race and ethnicity in a nationally representative sample. Methods and Results Using the National Health and Nutrition Examination Survey, we determined the distribution of ideal CVH, measured by Life’s Simple 7, across levels of educational attainment. We used multivariable ordinal logistic regression to assess the association between educational attainment (less than high school, high school graduate, some college, college graduate) and Life’s Simple 7 category (ideal, intermediate, poor), by race and ethnicity (Asian, Black, Hispanic, White). Covariates were age, sex, history of cardiovascular disease, health insurance, access to health care, and income–poverty ratio. Of 7771 National Health and Nutrition Examination Survey participants with complete data, as level of educational attainment increased, the criteria for ideal health were more often met for most metrics. After adjustment for covariates, effect of education was attenuated but remained significant (P<0.01). Those with at least a college degree had 4.12 times the odds of having an ideal Life’s Simple 7 compared with less than high school (95% CI, 2.70–5.08). Among all racial and ethnic groups, as level of educational attainment increased, so did Life’s Simple 7. The magnitude of the association between education and CVH varied by race and ethnicity (interaction P<0.01). Conclusions Our findings demonstrate that educational attainment has distinct associations with ideal CVH that differs by race and ethnicity. This work demonstrates the need to elucidate barriers preventing individuals from racial and ethnic minority groups from achieving equitable CVH.https://www.ahajournals.org/doi/10.1161/JAHA.121.023438cardiovascular healtheducational statusrace and ethnicity |
| spellingShingle | Amber E. Johnson Brandon M. Herbert Natalie Stokes Maria M. Brooks Belinda L. Needham Jared W. Magnani Educational Attainment, Race, and Ethnicity as Predictors for Ideal Cardiovascular Health: From the National Health and Nutrition Examination Survey Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiovascular health educational status race and ethnicity |
| title | Educational Attainment, Race, and Ethnicity as Predictors for Ideal Cardiovascular Health: From the National Health and Nutrition Examination Survey |
| title_full | Educational Attainment, Race, and Ethnicity as Predictors for Ideal Cardiovascular Health: From the National Health and Nutrition Examination Survey |
| title_fullStr | Educational Attainment, Race, and Ethnicity as Predictors for Ideal Cardiovascular Health: From the National Health and Nutrition Examination Survey |
| title_full_unstemmed | Educational Attainment, Race, and Ethnicity as Predictors for Ideal Cardiovascular Health: From the National Health and Nutrition Examination Survey |
| title_short | Educational Attainment, Race, and Ethnicity as Predictors for Ideal Cardiovascular Health: From the National Health and Nutrition Examination Survey |
| title_sort | educational attainment race and ethnicity as predictors for ideal cardiovascular health from the national health and nutrition examination survey |
| topic | cardiovascular health educational status race and ethnicity |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.023438 |
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