We will write a custom Critical Writing on The Role of Race and Ethnicity in Cardiovascular Health specifically for you
301 certified writers online
The key resource on the current cardiovascular health of the U.S. residents is the American Heart Association, which produces annual reports on the prevalence of cardiovascular diseases and stroke across the U.S. population. For instance, the 2016 report states that cardiovascular diseases account for 30.8% of all deaths in the U. S., even though the death rates attributable to CVS declined by 28.8% between 2003 and 2013 .
The risk factors for CVD include cigarette smoking, physical inactivity, high lipid values, and excess weight . The concept of ideal cardiovascular health was invented by the AHA in 2011 to outline the goals of the organization in the ten-year period. The ideal cardiovascular health is indicated by seven metrics, which include health behaviors and individual health factors, as well as by the absence of clinically manifested CVD . The seven metrics of the ideal CVH include “not smoking and having a healthy diet pattern, sufficient PA, normal body weight, and normal levels of TC, BP, and fasting blood glucose in the absence of drug treatment” .
The study by Mujahid et al. aims to determine the differences in ideal CVH across the different neighborhoods, races, and ethnicities. The AHA mentions that certain cardiovascular health predictors vary significantly between different neighborhoods, as well as ethnic and racial backgrounds . The role of race and ethnicity in cardiovascular health has been addressed in several recent studies; however, Mujahid et al. consider the racial and ethnic differences in the light of neighborhood factors, thus offering a new way of looking at these differences .
The researchers use secondary data from the 2002 Multi-Ethnic Study of Atherosclerosis baseline sample (MESA). The study sample included 6191 participants who consented to participate in the ancillary MESA Neighborhood Study. The authors examined the seven indicators of the ideal CVH among the participants, referring either to the clinical test results or the self-reported questionnaire data. Stata version 12 was used to analyze the data. The key independent variables addressed in the study included race, ethnicity, and neighborhood characteristics. The dependent variables included the seven individual components of the ideal SVH and the overall CVH score.
Overall, the study showed that ideal cardiovascular health was only experienced by 4.1% of the study sample, which varied in terms of age, education, and neighborhood characteristics, although the prevalence of ideal CVH was highest among younger participants with high levels of education and family income . In terms of race and ethnicity, ideal CVH was more prevalent in white residents (6.5%) than in Hispanic (2.2%) and Black participants (2%). Poor overall CVH, on the other hand, was most prevalent among the Hispanic participants (66.9%), followed by Black (64.9%) and white respondents (46.5%). The authors note that “Adjustment for neighborhood context slightly reduced racial/ ethnic differences, but differences remained statistically significant” .
Strengths and Limitations
The main strengths of the study are its large scope and the methods of analysis. The authors provided a detailed description of all the stages in analysis and made appropriate efforts to ensure that the results are reliable and presented in a clear and coherent manner. The tables that illustrate the racial and ethnic differences in the health factors and behavior are useful in reviewing the results of the study.
The procedures chosen by the authors were appropriate to the study design and worked to eliminate the bias where possible. It is also important that the authors addressed a variety of different neighborhood characteristics, as well as individual variables, including education and income level, as these differences proved to be statistically significant in predicting better cardiovascular health outcomes.
The primary limitation of the study, however, is that it uses secondary data collected in 2000-2002. Although it allows for a higher magnitude of the research and it is unlikely that the correlations between individual factors and health outcomes have changed over the past years, using recent data would help to avoid bias and ensure that the results are reliable and relevant to the current population. Another important limitation of the study is that the authors do not discuss the demographic characteristics that could affect the applicability of the research to the current settings. For instance, the authors could have addressed the neighborhood changes that occurred in the sample neighborhoods since 2002, thus suggesting how these changes would affect the results of the research.
Overall, the study adds to the existing research on the differences in cardiovascular health between different backgrounds. The study is relevant to the epidemiology of cardiovascular diseases as it suggests that certain population characteristics, such as the level of income and education, as well as racial and ethnic differences, predict the state of people’s cardiovascular health. However, the findings of the study are mostly in line with the current knowledge of cardiovascular health predictors, as outlined by the AHA .
One of the possible ways to improve the applicability of the study to the current healthcare settings is by conducting primary research with similar aims and variables studied. This would ensure that the findings and conclusions discussed by the authors still apply to the various U.S. populations and can be used in health policies to promote the AHA cardiovascular health goals.
Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha, MJ, Cushman M, Das SR, de Ferranti S, Després JP, Fullerton HJ, Howard VJ. Heart disease and stroke statistics—2016 update. Circulation. 133(4):38-360.
Mujahid MS, Mooreb LV, Petitoc LC, Kershawd KN, Watsone K, Diez Rouxf AV. Neighborhoods and racial/ethnic differences in ideal cardiovascular health (the Multi-Ethnic Study of Atherosclerosis). Health & Place. 44(1):61-69.