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The Effects of Socioeconomic Position on Black-White Crossover Effects in CVD Mortality

The Effects of Socioeconomic Position on Black-White Crossover Effects in CVD Mortality. Rhonda Jones-Webb 1 Jennifer O’Brien 1 Xinhua Yu 1 John Oswald 2 1 University of Minnesota, School of Public Health 2 Minnesota Department of Health, Center for Health Statistics.

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The Effects of Socioeconomic Position on Black-White Crossover Effects in CVD Mortality

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  1. The Effects of Socioeconomic Position on Black-White Crossover Effects in CVD Mortality Rhonda Jones-Webb 1 Jennifer O’Brien1 Xinhua Yu1 John Oswald2 1 University of Minnesota, School of Public Health 2 Minnesota Department of Health, Center for Health Statistics

  2. GOAL AND AIMS OF STUDY GOAL:To investigate the effects of socioeconomic position on black-white crossover effects in CVD mortality among black and white adults age 45 years and older in Minnesota between 1990-1998 AIMS:1. Assess whether CVD deaths differ between younger and older African Americans and Whites 2. Assess how socioeconomic position as measured by education and neighborhood poverty influence black-white crossover effects in CVD mortality

  3. HYPOTHESES Younger black men and women will have higher crude CVD mortality rates than younger white men and women; the reverse will be true for older black and white men. In contrast to previous studies, CVD mortality rates will vary by socioeconomic position among younger and older black and white men and women black.

  4. HYPOTHESES • Among younger and older men and women • Less educated blacks will have higher CVD mortality rates than less educated whites. CVD mortality rates will however be comparable among blacks and whites of higher educational status. • Blacks living in impoverished neighborhoods will have higher CVD mortality rates than whites living in impoverished neighborhoods. CVD rates will be comparable among blacks and whites living in less impoverished neighborhoods.

  5. DATAStudy based on data from MDH mortality files SUBJECTS1048black and 45,158 white Minnesotans who died from CVD between 1990 and 1998 DESIGN Longitudinal study design (data collapsed across study years) OUTCOMES CVD death rates DEMOGRAPHICS Race Sex Age Education Neighborhood poverty ANALYSIS Generalized linear model METHODS

  6. CVD ICD 9 CODES Codes 390-398 Rheumatic heart disease including fever Codes 401- 403, 405 Hypertension without heart disease Codes 402-404 Hypertension with heart disease Codes 410-414 Ischemic heart disease Codes 420-423, 425-428, 429.2, 429.9 Other diseases of the heart

  7. CVD ICD 9 CODES - continued Code 424 Chronic diseases of the endocardium Codes 429.0, 429.1 Other myocardial degeneration Codes 430-438 Cerebrovascular disease Codes 415-417, 441-450 Diseases of the arteries and veins Codes 440 Arteriosclerosis

  8. Table 1. Number of CVD Deaths with Missing Zip Codes by Race and Sex

  9. Table 2. Characteristics of Restricted Samples

  10. Figure 1. CVD Mortality Rates for Ages 45-64

  11. Table 3: CVD Adjusted Mortality Rates for Ages 45-64

  12. Table 4: CVD Mortality Rates by Race and Poverty Level for Ages 65+

  13. SUMMARY • Hypothesis 1 was not supported. A black-white cross-over effect in crude CVD mortality rates was not observed. Hypothesis 2 was not supported. Interaction effects were not observed of race with education and CVD mortality among younger men and women. • Hypothesis 3 was partially supported. Interaction effects were observed of race and with neighborhood poverty and CVD mortality among older men and women. Black men living in impoverished areas were significantly more likely to die of CVD than white men living impoverished neighborhoods. CVD mortality rates were more comparable among black and white men living in less impoverished neighborhoods.

  14. LIMITATIONS • Neighborhood poverty was assessed at the zip code level; results may differ had we used a smaller geographical unit of analysis such as the census block group. Previous studies have focused on smaller geographical units. • The numbers of older black men who died from CVD and who lived in less impoverished neighborhoods was small. • Study did not control for behavioral factors.

  15. The Effects of Socioeconomic Position on Black-White Crossover Effects in CHD Mortality • Rhonda Jones-Webb 1 • Jennifer O’Brien1 • Xinhua Yu1 • John Oswald2 • 1 University of Minnesota, School of Public Health • 2 Minnesota Department of Health, Center for Health Statistics

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