Receipt of high-quality coronary heart disease care in the United States: all about being black or white: comment on "Racial differences in admissions to high-quality hospitals for coronary heart disease".
[Show abstract][Hide abstract] ABSTRACT: Black women experience higher rates of cardiovascular disease (CVD) than white women, though evidence for racial differences in subclinical CVD is mixed. Few studies have examined multiple roles (number, perceived stress, and/or reward) in relation to subclinical CVD, or whether those effects differ by race.
The aim of this study was to investigate the effects of multiple roles on 2-year progression of coronary artery calcium.
Subjects were 104 black and 232 white women (mean age 50.8 years). Stress and reward from four roles (spouse, parent, employee, caregiver) were assessed on five-point scales. Coronary artery calcium progression was defined as an increase of ≥10 Agatston units.
White women reported higher rewards from their multiple roles than black women, yet black women showed cardiovascular benefits from role rewards. Among black women only, higher role rewards were related significantly to lower progression of coronary artery calcium, adjusting for body mass index, blood pressure, and other known CVD risk factors. Blacks reported fewer roles but similar role stress as whites; role number and stress were unrelated to coronary artery calcium progression.
Rewarding roles may be a novel protective psychosocial factor for progression of coronary calcium among black women.
Annals of Behavioral Medicine 09/2011; 43(1):39-49. DOI:10.1007/s12160-011-9307-8 · 4.20 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Those who practice medicine in the United States are unavoidably confronted by the fact that health status, disease burden and lifespan vary by population groups - particularly the persistent reality that cardiovascular disease outcomes are poorer in African Americans compared to European Americans (the majority reference group), Asian Americans (those from China and Japan having best outcomes, those from South Asia having higher disease burden at younger ages) and Hispanic Americans (who experience better than expected outcomes despite having many risk factors). The causes for population variation in health outcomes are multifactorial and can include biologic, environmental (physical and social), genetic, epigenetic and social determinants, a mixture of disparities and differences.
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