Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2009;54(3):166-74.
doi: 10.1007/s00038-008-7030-4.

Education differentials by race and ethnicity in the diagnosis and management of hypercholesterolemia: a national sample of U.S. adults (NHANES 1999-2002)

Sharon Stein Merkin  1 , Arun Karlamangla, Eileen Crimmins, Susan L Charette, Mark Hayward, Jung Ki Kim, Brandon Koretz, Teresa Seeman
Affiliations
Comparative Study

Education differentials by race and ethnicity in the diagnosis and management of hypercholesterolemia: a national sample of U.S. adults (NHANES 1999-2002)

Sharon Stein Merkin et al. Int J Public Health. 2009.

Abstract

Objectives: To examine education differentials in screening, awareness, treatment and control of hypercholesterolemia overall and in 3 race/ethnic groups.

Methods: We analyzed data for a nationally representative sample of 8,429 men and women ages 20 to 85 years, self-reported as white, black, Mexican American, or other race/ethnicity, who participated in the National Health and Nutrition Examination Survey from 1999-2002.

Results: Participants with < high school education were 2.5 times less likely than participants with > or = high school education to have been screened for hypercholesterolemia, after adjusting for age and gender (odds ratio: 0.4, 95 % confidence interval: 0.3-0.5, and similar across race/ethnic group). Multivariable models for awareness, treatment and control showed no significant trends associated with education after adjusting for age, gender, race and comorbidities.

Conclusions: Higher education significantly increased the odds of being screened for hypercholesterolemia overall and within each race/ethnic group. Education differentials were strongest for hypercholesterolemia screening, and weak or no longer apparent for subsequent steps of awareness, treatment and control. Focusing public health policy on increasing screening for individuals with low education might greatly improve their chances of preventing or mitigating morbidity related to hypercholesterolemia and subsequent cardiovascular disease.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest

None

Figures

Figure 1
Figure 1
NCEP Adult Treatment Panel II Guidelines (1994)
Figure 2
Figure 2
Sequential outcomes for diagnosis and management of hypercholesterolemia for the study sample
See this image and copyright information in PMC

References

    1. National Cholesterol Education Program (NCEP) Expert Panel. Second Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults. Circulation. 1994;89(3):1333–1445. - PubMed
    1. Kaplan GA, Keil JE. Socioeconomic factors and cardiovascular disease: a review of the literature. Circulation. 1993 Oct;88(4 Pt 1):1973–1998. - PubMed
    1. Winkelby MA, Jatulis DE, Frank E, Fortmann SP. Socioeconomic status and health: how education, income and occupation contribute to risk factors for cardiovascular disease. Am J Public Health. 1992;82:816–820. - PMC - PubMed
    1. Fiscella K, Franks P. Should years of schooling be used to guide treatment of coronary risk factors? Annals of Family Medicine. 2004;2(5):469–473. - PMC - PubMed
    1. Davis SK, Ahn DK, Fortmann SP, Farquhar JW. Determinants of cholesterol screening and treatment patterns. Am J Prev Med. 1998;15(3):178–186. - PubMed

Publication types

MeSH terms