Racial, Ethnic, and Geographic Disparities in Cardiovascular Health Among Women of Childbearing Age in the United States

J Am Heart Assoc. 2021 Sep 7;10(17):e020138. doi: 10.1161/JAHA.120.020138. Epub 2021 Aug 25.

Abstract

Background In the United States, large disparities in cardiovascular health (CVH) exist in the general population, but little is known about the CVH status and its disparities among women of childbearing age (ie, 18-49 years). Methods and Results In this cross-sectional study, we examined racial, ethnic, and geographic disparities in CVH among all women of childbearing age in the United States, using the 2011 to 2019 Behavioral Risk Factor Surveillance System. Life's Simple 7 (ie, blood pressure, glucose, total cholesterol, smoking, body mass index, physical activity, and diet) was used to examine CVH. Women with 7 ideal CVH metrics were determined to have ideal CVH. Among the 269 564 women of childbearing age, 13 800 (4.84%) had ideal CVH. After adjusting for potential confounders, non-Hispanic Black women were less likely to have ideal CVH (odds ratio, 0.54; 95% CI, 0.46-0.63) compared with non-Hispanic White women, and with significantly lower odds of having ideal metrics of blood pressure, blood glucose, body mass index, and physical activity. No significant difference in CVH was found between non-Hispanic White and Hispanic women. Large geographic disparities with temporal variations were observed, with the age- and race-adjusted ideal CVH prevalence ranging from 4.05% in the District of Columbia (2011) to 5.55% in Maine and Montana (2019). States with low ideal CVH prevalence and average CVH score were mostly clustered in the southern United States. Conclusions Large racial, ethnic, and geographic disparities in CVH exist among women of childbearing age. More efforts are warranted to understand and address these disparities.

Keywords: cardiovascular health; geographic disparities; racial disparities.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Blood Glucose
  • Blood Pressure
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / ethnology
  • Cross-Sectional Studies
  • Ethnicity
  • Female
  • Geography
  • Health Status
  • Health Status Disparities*
  • Humans
  • Middle Aged
  • Race Factors
  • Risk Factors
  • United States / epidemiology
  • Young Adult

Substances

  • Blood Glucose