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A 10-year trend in income disparity of cardiovascular health among older adults in South Korea.

ABSTRACT: Objectives:Although cardiovascular disease (CVD) risk has lessened in Korea, it is unclear whether older adults in all socioeconomic strata have benefited equally. This study explored trends in income disparities in CVD risk among older adults in Korea. Methods:This was a secondary analysis of Korean National Health and Nutrition Examination Survey data (2008-2017), targeting 14,836 older adults (?65 years). Socioeconomic position, defined as income and use of welfare benefits, was the primary indicator. The outcome was binary for predicted CVD risk (<90th vs. ? 90th). The Slope Index of Inequality (SII) and Relative Index of Inequality (RII) were used to assess trends in disparities. Results:The percentage of older adults with a predicted CVD risk of 90% or more declined over time, but this was due to a decrease among the more affluent. Disparities have persisted since 2012, with a worsening trend seen for Medicaid recipients. We found significant absolute and relative disparities among men over 75 years of age in recent years (SII > 0.19, RII > 7). Conclusions:These results may inform and improve policies regarding income disparity reduction and cardiovascular health.

SUBMITTER: Lee C

PROVIDER: S-EPMC7589532 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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A 10-year trend in income disparity of cardiovascular health among older adults in South Korea.

Lee Chiyoung C Yang Qing Q Im Eun-Ok EO McConnell Eleanor Schildwachter ES Jung Sin-Ho SH Kim Hyeoneui H

SSM - population health 20201020

<h4>Objectives</h4>Although cardiovascular disease (CVD) risk has lessened in Korea, it is unclear whether older adults in all socioeconomic strata have benefited equally. This study explored trends in income disparities in CVD risk among older adults in Korea.<h4>Methods</h4>This was a secondary analysis of Korean National Health and Nutrition Examination Survey data (2008-2017), targeting 14,836 older adults (≥65 years). Socioeconomic position, defined as income and use of welfare benefits, wa ...[more]

PMID: 33134476

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Project description:BackgroundDue to the rapid growth of the older adult population, multimorbidity has become a global concern for an aging society. Multimorbidity has been associated with poor health outcomes, including low quality of life and a high risk of mortality, resulting in an overload of healthcare systems. However, multimorbidity incidence and its related factors are poorly understood among older adults. This study aimed to determine whether sociodemographic characteristics, lifestyle, and psychosocial factors predict multimorbidity incidence among older adults in Korea.MethodsThis longitudinal study used the Korean Longitudinal Study of Aging (KLoSA) dataset from 2008 to 2018. The KLoSA is a panel survey of nationally representative samples aimed at providing data for developing socioeconomic policies for the increasing aging population in Korea. The study sample included 1967 older adults aged 65 years and over who had none or one of the chronic diseases at the baseline in 2008. Multimorbidity incidence was defined as the co-existence of two or more chronic diseases among 12 doctor-diagnosed diseases based on self-reports. Cox's proportional hazards models were used to identify significant predictors of multimorbidity incidence over a 10-year follow-up period.ResultsAmong 1967 respondents (female 54.5%, mean age 72.94), 625 (31.8%) incidents of multimorbidity were reported, contributing to 47.5 incidents per 1000 people after 10 years of follow-up. Low levels of social interaction, obesity, past smoking habits, and current or past drinking habits were identified as significant predictors of multimorbidity incidence among older adults in Korea.ConclusionsThis study identified older adults at high risk for multimorbidity incidence. These groups require more attention from health care providers in the course of chronic disease monitoring and management. Specific interventions and health policies to promote social interaction and a healthy lifestyle are essential to delay multimorbidity incidence. This longitudinal approach will contribute to developing preventive strategies to reduce the incidence of multimorbidity among older adults.

Project description:Objective: Associations between income disparity and utilization of cardiovascular disease (CVD) preventive care services, such as receipt of lifestyle advice and screening for CVD risk factors in populations with and without CVD, are not well understood. The purpose of this study was to evaluate associations between income and utilization of CVD-preventive services among U.S. adults.Methods: We included adults ≥18 years with and without CVD from the 2006 to 2015 Medical Expenditure Panel Survey. We categorized participants as high-income (>400% of federal poverty level [FPL]), middle income (200-400% of FPL), low-income (125-200% of FPL) and very low (VL)-income (<125% of FPL). We used logistic regression to compare the likelihood of receiving CVD-preventive services by income strata, adjusting for sociodemographic factors and comorbidities.Results: The study included 185,081 participants (representing 194.6 million U.S. adults) without CVD, and 32,862 participants (representing 37 million U.S. adults) with CVD. VL-income adults without CVD were less likely than high-income adults to have blood pressure measured within past 2 years [odds ratio [OR] 0.41 (95% confidence interval [CI] 0.37-0.45)] or cholesterol levels checked within past 5 years [0.36 (0.33-0.38)] or receive counseling about diet modifications [0.77 (0.74-0.81)], exercise [0.81 (0.77-0.85)], or smoking cessation [0.71 (0.63-0.79)] within past year. VL-income adults with CVD were also less likely to have blood pressure [0.32 (0.22-0.46)] or cholesterol [0.33 (0.26-0.42)] checked and receive counseling about exercise [0.84 (0.76-0.93)] or smoking cessation [0.78 (0.61-0.99)]. Additional subgroup analyses restricted to participants who had seen a healthcare provider within the preceding 12 months, as well as secondary analyses stratified by sex, race and ethnicity, showed similar disparities between high-income and VL-income participants.Conclusions: VL-income adults were less likely to be screened for CVD risk factors or receive CVD-prevention counseling than high-income adults, regardless of CVD status. More work must be done to reduce disparities in access to and utilization of CVD-preventive services among adults in different income groups.

Project description:IntroductionCardiovascular disease is a leading cause of mortality in the U.S. Although the risk of cardiovascular disease can be mitigated substantially by following a healthy lifestyle, adhering to a healthy diet and other healthy behaviors are limited by reduced food security. This study aims to determine the association between food security and cardiovascular disease risk.MethodsThree samples from the 2007-2014 National Health and Nutrition Examination Survey were examined: (1) 7,340 non-fasting adults (aged 40-79 years); (2) 13,518 non-fasting adults (aged 20-64 years); and (3) 6,494 fasting adults (aged 20-64 years). Food security was assessed using the U.S. Household Food Security Survey Module, with households categorized as having full, marginal, low, or very low food security. Regressions were conducted in 2018 to test the associations between food security status and odds of ≥20% 10-year cardiovascular disease risk among middle-aged to older adults (OR, 95% CI) and cardiovascular disease risk factors among all adults (β, 95% CI).ResultsCompared with adults with full food security, those with very low food security had higher odds of ≥20% 10-year cardiovascular disease risk (OR=2.36, 95% CI=1.25, 4.46), whereas those with marginal food security had higher systolic blood pressure (β=0.94 mmHg, 95% CI=0.09, 1.80). Compared with adults with full food security, adults with different levels of food security had higher BMIs (marginal: 0.76, 95% CI=0.26, 1.26; low: 0.97, 95% CI=0.34, 1.60; and very low: 1.03, 95% CI=0.44, 1.63) and higher odds of current smoking (marginal: OR=1.43, 95% CI=1.17, 1.75; low: OR=1.47, 95% CI=1.22, 1.77; and very low: OR=1.95, 95% CI=1.60, 2.37).ConclusionsAdults with food insecurity have elevated cardiovascular disease risk factors and excess predicted 10-year cardiovascular disease risk. Substantially improving food security may be an important public health intervention to reduce future cardiovascular disease in the U.S.Population

Dataset Information

A 10-year trend in income disparity of cardiovascular health among older adults in South Korea.

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A 10-year trend in income disparity of cardiovascular health among older adults in South Korea.

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