Association Between Discrimination in Health Care and Atherosclerotic Cardiovascular Disease (ASCVD) Among Middle-Aged and Older Adults in the United States
- Cohort study using Health and Retirement Study data
- propensity score weights
- Cox models
- followed for up to 12 years
+3 more
- propensity score weights
- Cox models
- followed for up to 12 years
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
Main finding
As reported in the abstract
Reported discrimination by ASCVD event status
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 | |
|---|---|---|
| Nonfatal ASCVD · 2, 5 and 10 years — Discrimination vs No discrimination · first 2-years of follow-up · propensity score weights | 1.54 (95% CI 1.24–1.91) | |
| Nonfatal ASCVD · 2, 5 and 10 years — Discrimination vs No discrimination · after 5 years · propensity score weights | 1.29 (CI 1.11–1.50) | |
| Nonfatal ASCVD · 2, 5 and 10 years — Discrimination vs No discrimination · propensity score weights | 1.27 (CI 1.10–1.46) | |
| Nonfatal ASCVD · 2, 5 and 10 years — Discrimination vs No discrimination · 2-year, after covariate adjustments · propensity score weights | 1.44 (CI 1.16–1.80) | |
| Nonfatal ASCVD · 2, 5 and 10 years — Discrimination vs No discrimination · 5-year, after covariate adjustments · propensity score weights | 1.24 (CI 1.06–1.44) | |
| Nonfatal ASCVD · 2, 5 and 10 years — Discrimination vs No discrimination · 10-year, after covariate adjustments · propensity score weights | 1.23 (CI 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:10.1161/circoutcomes.125.012661
Summarised from the published abstract; every number is checked against it