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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 73 Research Studies DisplayedOates GR, Hamby BW, Bae S
Bikeshare use in urban communities: individual and neighborhood factors.
This study examined factors associated with bikeshare use in a metropolitan area in the southern United States. The study found that higher neighborhood socioeconomic disadvantage was associated with higher bikeshare use. Bikeshare was a viable transportation option in low-resource neighborhoods and may be an effective tool to improve the connectivity, livability, and health of urban communities.
AHRQ-funded; HS023009.
Citation: Oates GR, Hamby BW, Bae S .
Bikeshare use in urban communities: individual and neighborhood factors.
Ethn Dis 2017 Nov 9;27(Suppl 1):303-12. doi: 10.18865/ed.27.S1.303..
Keywords: Health Status, Social Determinants of Health, Urban Health
Tung EL, Johnson TA, O'Neal Y
Experiences of community violence among adults with chronic conditions: qualitative findings from Chicago.
The purpose of this study was to explore and characterize, using a qualitative study design, self-described experiences of community violence among adults with chronic health conditions. Investigators found that patients often struggled to balance the challenges imposed by community violence with the demands of living with and managing their chronic conditions.
AHRQ-funded; HS023007.
Citation: Tung EL, Johnson TA, O'Neal Y .
Experiences of community violence among adults with chronic conditions: qualitative findings from Chicago.
J Gen Intern Med 2018 Nov;33(11):1913-20. doi: 10.1007/s11606-018-4607-3..
Keywords: Chronic Conditions, Disparities, Social Determinants of Health
Masho SW, Rozario S, Walker D
Racial differences and the role of marital status in the association between intimate partner violence and unintended pregnancy.
This study examined the association between intimate partner violence (IPV) and unintended pregnancy across racial/ethnic and marital strata among U.S. women. Among other results, the investigators found that the odds of unintended pregnancy were increased for married non-Hispanic White women who reported IPV compared to their non-abused counterparts even after controlling for sociodemographic factors, health care access, and reproductive history.
AHRQ-funded; HS021504.
Citation: Masho SW, Rozario S, Walker D .
Racial differences and the role of marital status in the association between intimate partner violence and unintended pregnancy.
J Interpers Violence 2018 Oct;33(20):3162-85. doi: 10.1177/0886260516635317..
Keywords: Domestic Violence, Pregnancy, Racial and Ethnic Minorities, Social Determinants of Health
Washington DM, Curtis LM, Waite K
Sociodemographic factors mediate race and ethnicity-associated childhood asthma health disparities: a longitudinal analysis.
This study characterized the longitudinal effects associated with being African-American/Black or Hispanic/Latino on a range of asthma outcomes, and the extent to which sociodemographic factors, caregiver health literacy, education level, and asthma knowledge mediated these associations. The investigators concluded that African-American race and Hispanic/Latino ethnicity are significantly associated with worse asthma compared to Whites in longitudinal analyses.
AHRQ-funded; HS022242.
Citation: Washington DM, Curtis LM, Waite K .
Sociodemographic factors mediate race and ethnicity-associated childhood asthma health disparities: a longitudinal analysis.
J Racial Ethn Health Disparities 2018 Oct;5(5):928-38. doi: 10.1007/s40615-017-0441-2..
Keywords: Asthma, Children/Adolescents, Disparities, Racial and Ethnic Minorities, Social Determinants of Health
Zuckerman KE, Lindly OJ, Reyes NM
Parent perceptions of community autism spectrum disorder stigma: measure validation and associations in a multi-site sample.
In this study, the investigators developed a brief, English/Spanish bilingual parent-reported scale of perceived community autism spectrum disorder (ASD) stigma and tested it in a multi-site sample of Latino and non-Latino white parents of children with ASD.
AHRQ-funded; HS000063.
Citation: Zuckerman KE, Lindly OJ, Reyes NM .
Parent perceptions of community autism spectrum disorder stigma: measure validation and associations in a multi-site sample.
J Autism Dev Disord 2018 Sep;48(9):3199-209. doi: 10.1007/s10803-018-3586-x..
Keywords: Autism, Disabilities, Social Stigma, Social Determinants of Health, Behavioral Health
Nelson DB, Moniz MH, Davis MM
Population-level factors associated with maternal mortality in the United States, 1997-2012.
This study analyzed state-level maternal mortality for the years 1997-2012 using multilevel mixed-effects regression grouped by state, using publicly available data. The study concluded that, in addition to better case ascertainment of maternal deaths, adverse changes in chronic diseases, insufficient healthcare access, and social determinants of health represent identifiable risks for maternal mortality that merit prompt attention in population-directed interventions and health policies.
AHRQ-funded; HS025465.
Citation: Nelson DB, Moniz MH, Davis MM .
Population-level factors associated with maternal mortality in the United States, 1997-2012.
BMC Public Health 2018 Aug 13;18(1):1007. doi: 10.1186/s12889-018-5935-2..
Keywords: Health Services Research (HSR), Labor and Delivery, Mortality, Pregnancy, Social Determinants of Health
Sentell TL, Shen C, Landsittel D
Racial/ethnic differences in those accompanying Medicare patients to the doctor: insights from the 2013 Medicare current beneficiary's survey.
This study used multivariable models applied to Medicare Current Beneficiary's Survey Access to Care public use data in order to predict companion accompaniment to health care providers among Medicare beneficiaries; Chi square analyses compared, by race/ethnicity, who was accompanying patients and why. Black and Hispanic patients were more likely to be accompanied than whites. In all three groups, more than a third of patients brought someone with them to ‘take notes,’ ‘ask questions,’ and/or ‘explain things,’ but significantly more Hispanic patients brought a companion to ‘explain instructions,’ ‘translate,’ and/or to provide ‘moral support.’ The authors conclude that many Medicare beneficiaries are accompanied to doctors' appointments, particularly among minority racial/ethnic groups, and that this should be taken in consideration in healthcare policy and practice.
AHRQ-funded; HS023185.
Citation: Sentell TL, Shen C, Landsittel D .
Racial/ethnic differences in those accompanying Medicare patients to the doctor: insights from the 2013 Medicare current beneficiary's survey.
J Immigr Minor Health 2018 Aug;20(4):776-83. doi: 10.1007/s10903-017-0582-8..
Keywords: Caregiving, Elderly, Medicare, Racial and Ethnic Minorities, Social Determinants of Health
Cottrell EK, Gold R, Likumahuwa S
Using health information technology to bring social determinants of health into primary care: a conceptual framework to guide research.
The investigators recently proposed a conceptual framework to illustrate how health information technology can be used to bring social determinants of health information into primary care. In this paper, they describe how they are putting this conceptual model into practice within the OCHIN network of community health centers by highlighting examples of ongoing research, identifying knowledge gaps, and outlining a roadmap of future research to move the field forward.
Citation: Cottrell EK, Gold R, Likumahuwa S .
Using health information technology to bring social determinants of health into primary care: a conceptual framework to guide research.
AHRQ-funded; 233201500020I..
Keywords: Health Information Technology (HIT), Primary Care, Research Methodologies, Social Determinants of Health
Jarman MP, Haut ER, Curriero FC
Mapping areas with concentrated risk of trauma mortality: a first step toward mitigating geographic and socioeconomic disparities in trauma.
This study sought to classify injury event locations based on features of the built and social environment at the injury scene, and to examine patterns in individual patient demographics, injury characteristics, and mortality by location class. The investigators concluded identification of location classes may be useful for targeted primary prevention and treatment interventions, both by identifying geographic areas with the highest risk of injury mortality and by identifying patterns of individual risk within location classes.
AHRQ-funded; HS000029.
Citation: Jarman MP, Haut ER, Curriero FC .
Mapping areas with concentrated risk of trauma mortality: a first step toward mitigating geographic and socioeconomic disparities in trauma.
J Trauma Acute Care Surg 2018 Jul;85(1):54-61. doi: 10.1097/ta.0000000000001883..
Keywords: Disparities, Injuries and Wounds, Mortality, Social Determinants of Health, Trauma
Jarman MP, Curriero FC, Haut ER
Associations of distance to trauma care, community income, and neighborhood median age with rates of injury mortality.
The purpose of this study was to examine the association of injury scene characteristics with injury mortality. The study concluded that injury scene characteristics are associated with injury mortality. The authors found that odds of death are highest for patients injured in communities with higher median age or lower per capita income and at locations farthest from level 1 or 2 trauma centers.
AHRQ-funded; HS000029.
Citation: Jarman MP, Curriero FC, Haut ER .
Associations of distance to trauma care, community income, and neighborhood median age with rates of injury mortality.
JAMA Surg 2018 Jun;153(6):535-43. doi: 10.1001/jamasurg.2017.6133..
Keywords: Access to Care, Mortality, Social Determinants of Health, Trauma, Injuries and Wounds
Gorski Findling MT, Wolfson JA, Rimm EB
Differences in the neighborhood retail food environment and obesity among US children and adolescents by SNAP participation.
The authors sought to understand the association between children's neighborhood food access and overweight/obesity in a national sample of US households, and whether this association differs by Supplemental Nutrition Assistance Program (SNAP) participation or household purchases. Using data from the National Household Food Acquisition and Purchase Survey, 2012-2013, they found that the odds of childhood overweight/obesity were higher with greater access to combination grocery/other stores overall and for children in SNAP. Eligible non-SNAP children had higher odds of overweight/obesity with greater access to convenience stores. The average child lived in a household with 6.3% of total spending at food outlets on sugary beverages. They concluded that greater neighborhood access to combination grocery/other stores is associated with higher obesity prevalence for children overall and those in SNAP.
AHRQ-funded; HS000055.
Citation: Gorski Findling MT, Wolfson JA, Rimm EB .
Differences in the neighborhood retail food environment and obesity among US children and adolescents by SNAP participation.
Obesity 2018 Jun;26(6):1063-71. doi: 10.1002/oby.22184.
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Keywords: Children/Adolescents, Low-Income, Nutrition, Obesity, Social Determinants of Health
Goodman SM, Mandi LA, Mehta B
Does education level mitigate the effect of poverty on total knee arthroplasty outcomes?
The authors assessed the interaction between education and poverty on 2-year Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function. They found that having no college was associated with worse pain and function at baseline and 2 years and that living in a poor neighborhood was associated with worse 2-year pain and function. There was a strong interaction between individual education and community poverty with WOMAC scores at 2 years. Patients without college living in poor communities had pain scores that were ~10 points worse than those with some college; in wealthy communities, college was associated with a 1-point difference in pain. Function was similar. The authors recommended further study on how education protects those in impoverished communities.
AHRQ-funded; HS016075.
Citation: Goodman SM, Mandi LA, Mehta B .
Does education level mitigate the effect of poverty on total knee arthroplasty outcomes?
Arthritis Care Res 2018 Jun;70(6):884-91. doi: 10.1002/acr.23442..
Keywords: Arthritis, Education, Low-Income, Orthopedics, Outcomes, Patient-Centered Outcomes Research, Social Determinants of Health
Attanasio LB, Kozhimannil KB, Kjerulff KH
Factors influencing women's perceptions of shared decision making during labor and delivery: results from a large-scale cohort study of first childbirth.
The researchers examined correlates of shared decision making during labor and delivery. They found that women who were black and who did not have a college degree or private insurance were less likely to report high shared decision making, as well as women who underwent labor induction, instrumental vaginal or cesarean delivery.
AHRQ-funded; HS024215.
Citation: Attanasio LB, Kozhimannil KB, Kjerulff KH .
Factors influencing women's perceptions of shared decision making during labor and delivery: results from a large-scale cohort study of first childbirth.
Patient Educ Couns 2018 Jun;101(6):1130-36. doi: 10.1016/j.pec.2018.01.002.
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Keywords: Shared Decision Making, Disparities, Labor and Delivery, Patient-Centered Healthcare, Social Determinants of Health
Childers KK, Maggard-Gibbons M, Macinko J
National distribution of cancer genetic testing in the United States: evidence for a gender disparity in hereditary breast and ovarian cancer.
Identifying mutation carriers is critical for treatment decisions, cancer prevention, and early detection. This study analyzed the 2015 US National Health Interview Survey (NHIS), a cross-sectional in-person interview gathering self-reported health data for the US population. The study found that while cancer genetic testing seems to reach a broad geographic and sociodemographic population in the national survey, there remain underrepresented groups, including Hispanics, the uninsured, noncitizens, and those with less education.
AHRQ-funded; HS025079.
Citation: Childers KK, Maggard-Gibbons M, Macinko J .
National distribution of cancer genetic testing in the United States: evidence for a gender disparity in hereditary breast and ovarian cancer.
JAMA Oncol 2018 Jun;4(6):876-79. doi: 10.1001/jamaoncol.2018.0340..
Keywords: Cancer, Cancer: Breast Cancer, Cancer: Ovarian Cancer, Genetics, Racial and Ethnic Minorities, Screening, Social Determinants of Health, Women
Wong MS, Chan KS, Jones-Smith JC
The neighborhood environment and obesity: understanding variation by race/ethnicity.
The researchers examined the relationship between soda consumption and weight status with neighborhood sociodemographic, social, and built environments by race/ethnicity. Merging data on adults from the 2011-2013 California Health Interview Survey, U.S. Census data, and InfoUSA, they found that lower neighborhood educational attainment was associated with higher odds of obesity and soda consumption in all racial/ethnic groups. They found fewer associations between study outcomes and the neighborhood, especially the built environment, among non-Hispanic African Americans and non-Hispanic Asians. They concluded that, while improvements to neighborhood environment may be promising to reduce obesity, null associations among minority subgroups suggest that changes, particularly to the built environment, may alone be insufficient to address obesity in these groups.
AHRQ-funded; HS000029.
Citation: Wong MS, Chan KS, Jones-Smith JC .
The neighborhood environment and obesity: understanding variation by race/ethnicity.
Prev Med 2018 Jun;111:371-77. doi: 10.1016/j.ypmed.2017.11.029.
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Keywords: Disparities, Obesity, Racial and Ethnic Minorities, Social Determinants of Health
Roy B, Riley C, Herrin J
Identifying county characteristics associated with resident well-being: a population based study.
The authors aimed to identify county attributes that are independently associated with a comprehensive, multi-dimensional assessment of individual well-being. They identified twelve county-level factors that were independently associated with individual well-being scores. Collectively, these twelve factors explained 91% of the variance in individual well-being scores, and they represent four conceptually distinct categories: demographic; social and economic; clinical care; and physical environment.
AHRQ-funded; HS023000.
Citation: Roy B, Riley C, Herrin J .
Identifying county characteristics associated with resident well-being: a population based study.
PLoS One 2018 May 23;13(5):e0196720. doi: 10.1371/journal.pone.0196720.
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Keywords: Health Status, Quality of Life, Social Determinants of Health
Kato E, Borsky AE, Zuvekas SH
AHRQ Author: Kato E, Borsky AE, Zuvekas SH, Soni A, Ngo-Metzger Q
Missed opportunities for depression screening and treatment in the United States.
This study estimates the prevalence of depression assessment in adults age 35 and older and how prevalence varies by sociodemographic characteristics and depressive symptoms. It found that approximately 50 percent of US adults aged 35+ were being assessed for depression in 2014-2015. Certain populations were more likely to be missed, including men, people over 75 years old, minorities, and the uninsured.
AHRQ-authored.
Citation: Kato E, Borsky AE, Zuvekas SH .
Missed opportunities for depression screening and treatment in the United States.
J Am Board Fam Med 2018 May-Jun;31(3):389-97. doi: 10.3122/jabfm.2018.03.170406.
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Keywords: Depression, Medical Expenditure Panel Survey (MEPS), Prevention, Screening, Social Determinants of Health
Rising KL, Karp DN, Powell RE
Geography, not health system affiliations, determines patients' revisits to the emergency department.
This study sought to determine how frequently patients revisit the emergency department after an initial encounter, and to describe revisit capture rates for the same hospital, health system, and geographic region. Seventy percent of 30-day returns occurred to the same hospital. The 30-day return capture rates were highest within the same geographic area: county-level capture at 92 percent versus health system capture at 75 percent.
AHRQ-funded; HS023614.
Citation: Rising KL, Karp DN, Powell RE .
Geography, not health system affiliations, determines patients' revisits to the emergency department.
Health Serv Res 2018 Apr;53(2):1092-109. doi: 10.1111/1475-6773.12658.
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Keywords: Emergency Department, Healthcare Cost and Utilization Project (HCUP), Social Determinants of Health
Buys DR, Kennedy RE, Williams CP
Social and demographic predictors of nutritional risk: cross-sectional analyses from the UAB Study of Aging II.
Social factors may disparately affect access to food and nutritional risk among older adults by race and gender. This study assesses these associations using the Mini Nutritional Assessment among 414 community-dwelling persons 75+ years of age in Alabama. Multivariable analyses indicated that social factors affect nutritional risk differently by race and gender. Nutritional risk interventions are warranted for older adults.
AHRQ-funded; HS013852.
Citation: Buys DR, Kennedy RE, Williams CP .
Social and demographic predictors of nutritional risk: cross-sectional analyses from the UAB Study of Aging II.
Fam Community Health 2018 Apr/Jun;41 Suppl 2 Suppl, Food Insecurity and Obesity:S33-s45. doi: 10.1097/fch.0000000000000180.
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Keywords: Elderly, Nutrition, Obesity, Risk, Social Determinants of Health
Tung EL, Wroblewski KE, Boyd K
Police-recorded crime and disparities in obesity and blood pressure status in Chicago.
The purpose of this study was to examine associations between several types of police-recorded crime (violent, nonviolent, and homicide) and cardiometabolic health (obesity and elevated blood pressure [BP]), and to determine if associations were modified by age and sex. It concluded that in a densely populated, high-poverty region in Chicago, recurrent exposure to high rates of violent crime was consistently associated with obesity and elevated BP, but rare exposure to homicide was not.
AHRQ-funded; HS023007.
Citation: Tung EL, Wroblewski KE, Boyd K .
Police-recorded crime and disparities in obesity and blood pressure status in Chicago.
J Am Heart Assoc 2018 Mar 24;7(7). doi: 10.1161/jaha.117.008030.
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Keywords: Blood Pressure, Disparities, Risk, Social Determinants of Health, Urban Health
Lobo JM, Anderson R, Stukenborg GJ
Disparities in the use of diabetes screening in Appalachia.
This study examines disparities in the use of diabetes screening in Appalachia. Results showed that at-risk counties had significantly lower screening rates than competitive counties. Recommendations include introducing social policies that improve socioeconomic status and educational attainment, and health policies that reduce barriers to access to care in order to reduce disparities in diabetes screening rates in the less affluent Appalachian counties.
AHRQ-funded; HS018542.
Citation: Lobo JM, Anderson R, Stukenborg GJ .
Disparities in the use of diabetes screening in Appalachia.
J Rural Health 2018 Mar;34(2):173-81. doi: 10.1111/jrh.12247..
Keywords: Diabetes, Rural Health, Disparities, Social Determinants of Health, Screening, Prevention
Saavedra-Avendano B, Schiavon R, Sanhueza P
Who presents past the gestational age limit for first trimester abortion in the public sector in Mexico City?
This study identified socio-demographic factors associated with presenting for abortion services past the gestational age (GA) limit (12 weeks), and thus not receiving services, in Mexico City's public sector first trimester abortion program. Adult women had significantly lower odds than adolescents of presenting past the limit. There was an educational gradient across all age groups.
AHRQ-funded; HS022981.
Citation: Saavedra-Avendano B, Schiavon R, Sanhueza P .
Who presents past the gestational age limit for first trimester abortion in the public sector in Mexico City?
PLoS One 2018 Feb 7;13(2):e0192547. doi: 10.1371/journal.pone.0192547.
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Keywords: Education, Pregnancy, Social Determinants of Health, Women
Sun CJ, Sutfin E, Bachmann LH
Comparing men who have sex with men and transgender women who use Grindr, other similar social and sexual networking apps, or no social and sexual networking apps: implications for recruitment and health promotion.
This paper seeks to identify differences in men who have sex with men (MSM) and transgender women who use the Grindr app and those who use other similar apps. It found significant differences in the sociodemographic characteristics by app use, including age, race/ethnicity, sexual orientation, and outness. After adjusting for the sociodemographic characteristics associated with app use, there were significant differences in HIV risk and substance use between the groups.
AHRQ-funded; HS022981.
Citation: Sun CJ, Sutfin E, Bachmann LH .
Comparing men who have sex with men and transgender women who use Grindr, other similar social and sexual networking apps, or no social and sexual networking apps: implications for recruitment and health promotion.
J AIDS Clin Res 2018;9(2). doi: 10.4172/2155-6113.1000757.
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Keywords: Health Promotion, Human Immunodeficiency Virus (HIV), Risk, Social Determinants of Health, Vulnerable Populations
Cardet JC, Louisias M, King TS
Income is an independent risk factor for worse asthma outcomes.
The authors investigated whether low income, low education, and high perceived stress were independent risk factors for treatment failure and asthma exacerbations in the context of a randomized controlled trial. They found that participants with lower income were more likely to experience adverse asthma outcomes independent of education, perceived stress, race, and medication adherence.
AHRQ-funded; HS022986.
Citation: Cardet JC, Louisias M, King TS .
Income is an independent risk factor for worse asthma outcomes.
J Allergy Clin Immunol 2018 Feb;141(2):754-60.e3. doi: 10.1016/j.jaci.2017.04.036..
Keywords: Asthma, Chronic Conditions, Low-Income, Outcomes, Patient-Centered Outcomes Research, Risk, Social Determinants of Health
Valero-Elizondo J, Hong JC, Spatz ES
Persistent socioeconomic disparities in cardiovascular risk factors and health in the United States: Medical Expenditure Panel Survey 2002-2013.
This study aimed to describe the trends in prevalence of cardiovascular risk factors (CRFs) among US adults by SES from 2002 to 2013. It found that the proportion of individuals with obesity, diabetes and hypertension increased overall, with low-income groups representing a higher prevalence for each CRF. Of note, physical inactivity had the highest prevalence increase, with the "lowest-income" group observing a relative percent increase of 71.1 percent.
AHRQ-funded; HS023000.
Citation: Valero-Elizondo J, Hong JC, Spatz ES .
Persistent socioeconomic disparities in cardiovascular risk factors and health in the United States: Medical Expenditure Panel Survey 2002-2013.
Atherosclerosis 2018 Feb;269:301-05. doi: 10.1016/j.atherosclerosis.2017.12.014.
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Keywords: Disparities, Cardiovascular Conditions, Medical Expenditure Panel Survey (MEPS), Risk, Social Determinants of Health