Association Between Discrimination in Health Care and Atherosclerotic Cardiovascular Disease (ASCVD) Among Middle-Aged and Older Adults in the United States
Authors' conclusion
Discrimination in health care was associated with increased risks of nonfatal ASCVD in middle-aged and older adults. The risks persisted over time and suggest that discrimination is an important factor to consider for the prevention of ASCVD.
Study context
- Population
- Adults aged 50 to 90 years enrolled in the 2008 to 2020 waves of the Health and Retirement Studystudy participants (mean age: 65.86, 41.97% male)
- Participants
- 17,632 adults
- Exposure
- Discrimination in health care vs no discrimination, ASCVD risk
- Discriminationn = 3,347
- Outcome
- Reported discrimination by ASCVD event status
Methodological detailspropensity score weights, Cox models, followed for up to 12 years
- Propensity score weights
- Cox models
- Followed for up to 12 years
Main finding
As reported in the abstract
Reported discrimination, among those who did not have an event
2983
18.82%
Reported discrimination, among those who had an event
364
20.39%
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Nonfatal ASCVD · 2, 5 and 10 yearsDiscriminationvs No discriminationFirst 2-years of follow-up · propensity score weights | 1.54 (1.24–1.91) | |
| Nonfatal ASCVD · 2, 5 and 10 yearsDiscriminationvs No discriminationAfter 5 years · propensity score weights | 1.29 (1.11–1.50) | |
| Nonfatal ASCVD · 2, 5 and 10 yearsDiscriminationvs No discriminationPropensity score weights | 1.27 (1.10–1.46) | |
| Nonfatal ASCVD · 2, 5 and 10 yearsDiscriminationvs No discrimination2-year, after covariate adjustments · propensity score weights | 1.44 (1.16–1.80) | |
| Nonfatal ASCVD · 2, 5 and 10 yearsDiscriminationvs No discrimination5-year, after covariate adjustments · propensity score weights | 1.24 (1.06–1.44) | |
| Nonfatal ASCVD · 2, 5 and 10 yearsDiscriminationvs No discrimination10-year, after covariate adjustments · propensity score weights | 1.23 (1.10–1.46) | |
| 0.512Hazard ratio (log scale) |
Original publication
Association Between Discrimination in Health Care and ASCVD Among Middle-Aged and Older Adults in the United States. Circ Popul Health Outcomes. Published 1 May 2026. doi:10.
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