Social Determinants of Cardiovascular Disease among Michigan Residents: A Call to Action for Population Health Initiatives

Abstract

Objective: Little is known about the cardiovascular health (CVH) and social determinants of cardiovascular diseases (SDCVDs) among Michigan residents by race and ethnicity. Therefore, the objective of this cross-sectional study was to determine the CVH of Michigan residents and to examine the relationship between CVH and SDCVDs by race/ethnicity and age.

Methodology: Michigan-level data consisting of 10,889 participants was extracted from the 2017 Behavioral Risk Factor Surveillance System data. Descriptive statistics examined the adjusted proportions of the CVH measures and determined the adjusted mean CVH score for the SDCVDs among racial/ethnic groups by age. Generalized ordinal logistic regression analyses assessed the relationship between residents' CVH and SDCVDs by racial/ethnic status. All analyses were performed using STATA MP14.

Results: Residents from each racial/ethnic group did not meet the criteria for ideal BMI. The mean CVH score was found to be low for Black (2.65; 95% CI, 2.41-2.89) and Hispanic (2.84; 95% CI, 2.29-3.40) residents ≥ 50 years old with a high school degree or less. Black residents unemployed for more than a year were less likely to have a high CVH score (OR = 0.45; 95% CI, 0.21-80.97) compared with Black residents employed for wages.

Conclusion: Michigan residents' CVH is lacking across multiple dimensions. Multifaceted population health initiatives are warranted to address influential SDCVDs to diminish the CVH disparities identified across racial/ethnic and age groups.

Keywords: Cardiovascular disease; Cardiovascular health; Michigan; Population health; Social determinants of cardiovascular disease; Social determinants of health.