A person with a higher level of education generally has better cardiovascular health (CVH) than a person with a lower level of education. However, the benefits of greater education may not accrue to people from non-white racial and ethnic groups. Journal of the American Heart Association study published today by researchers from UPMC Cardiology and Vascular Institute and University of Pittsburgh School of Medicine.
Unlike previous research, this study examined the interaction between race and education level regarding ideal CVH instead of cardiovascular disease. Study participants represented considerable racial and socioeconomic diversity and used the The Seven Simples of Life (LS7) as a tool to assess CVH. LS7 includes seven risk factors that people can improve by making lifestyle changes to achieve ideal cardiovascular health, including blood pressure management, cholesterol control, lower blood sugar, physical activity, better diet, weight loss and smoking cessation.
“We know that education level can improve CVH measures, but we found that black people with higher levels of education are less likely to achieve an ideal CVH,” said Amber Johnson, MD, MS, MBA, UPMC Cardiologist and Assistant Professor of Medicine. to Pitt.
Johnson and his colleagues looked at more than 8,100 participants from across the United States who completed both a questionnaire and a medical exam and were at least 25 years old with no history of cardiovascular disease at the time of the exam. Comprehensive data on LS7, education, race and ethnicity, and key sociodemographic information (such as income and access to health care) were also available for these participants.
The results showed that a higher level of education does not outweigh the effect of race on CVH for black individuals.
For example, white participants with higher education had the highest odds of being in a higher LS7 category. In comparison, Hispanic and Black participants with the highest levels of education did not achieve similar gains in ideal CVH. In fact, there was a four-fold increase in ideal CVH for non-Hispanic whites with a bachelor’s degree or higher education, but only a three-fold increase for Hispanics and a two-fold increase for blacks. with the same level of education.
Johnson said minority populations continue to face barriers that reduce the potential health benefits of upward social mobility and higher levels of education compared to whites.
“It is important to interpret the results of these studies knowing that there are structural barriers and policy solutions that must be considered to address these findings,” Johnson said. “It boils down to the fact that these challenges include the social and structural determinants of health that need to be addressed.”
Johnson notes that more work is needed to understand the societal barriers preventing nonwhite individuals from achieving an ideal CVH. Future studies should test interventions aimed at overcoming race-based disparities despite access to quality education.
Co-authors of this research publication are Belinda L. Needham, Ph.D., University of Michigan School of Public Health; Brandon M. Herbert, MPH, Maria M. Brooks, Ph.D., Natalie Stokes, MD, and Jared W. Magnani, MD, MS, all of Pitt.
This work was supported by National Institutes of Health grant R33HL144669.
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CAPTION: Amber Johnson, MD, MS, MBA, UPMC Cardiologist and Assistant Professor of Medicine, University of Pittsburgh School of Medicine.