SSM - Population Health · 3 authors, 2 centres
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Using NHANES 2011–2018 data from 8,019 U.S. adults free of cardiovascular disease, this cross-sectional study applied Kitagawa-Blinder-Oaxaca decomposition to quantify how social and economic factors contribute to Black-White disparities in cardiovascular health by gender. Social and economic factors fully explained the CVH disparity among women but not among men, for whom no overall racial difference in CVH was detected.
This cross-sectional study analyzed nationally representative NHANES 2011–2018 data from 8,019 U.S. adults aged 20 years and older who were free of cardiovascular disease. CVH was assessed using eight behavioral and clinical indicators, and Kitagawa-Blinder-Oaxaca decomposition was used to quantify how five social and economic factors—education, income, employment, food security, and marital status—contributed to Black-White racial disparities in CVH by gender. Black women had a significantly lower age-adjusted CVH score than White women (mean difference = −3.01; 95% CI: −5.18, −0.84), and social and economic factors accounted for a 3.26-point disadvantage (95% CI: −4.12, −2.40), with income having the largest coefficient. Among men, despite social and economic disadvantages, no racial difference in age-adjusted CVH score was detected (mean difference = −0.28; 95% CI: −3.78, 3.22). Key limitations include the cross-sectional design precluding causal inference, potential measurement issues with CVH scores, possible selection bias, and inability to account for racial discrimination. The findings suggest equitable access to social and economic resources is necessary but may not be sufficient to eliminate CVH disparities.
