Cardiometabolic health of low- and higher-income adults in the United States, 2009-2023
- serial cross-sectional analysis
Authors' conclusion
Between 2009 and August 2023, there was no improvement in the prevalence of hypertension or high cholesterol. Obesity and diabetes prevalence rose among low-income adults and a new income-related gap in diabetes control emerged, coinciding with a greater-than-expected decline in glycemic control among low-income adults after the pandemic. Targeted efforts are needed to improve risk factor prevention, strengthen glycemic control in low-income populations, and address persistent income-related disparities in cardiometabolic health.
Study context
- Population
- National Health and Nutrition Examination Survey participants aged ≥ 18 years (2009–2010 to August 2021-August 2023), by income leveladults (mean age 46.3 years, 51.7% female)
- Participants
- 62,108 participants
- Exposure
- low- and higher-income adults
Main finding
As reported in the abstract
- did not change in either income group
Observational data: associations, not effects.
Further findings
Diabetes prevalence
absolute difference (pp) +5.2 (1.6–8.8)
change low-income +5.1 pp [1.4, 8.8] · higher-income +2.5 pp [0.7, 4.3]
| Outcome | low-income | higher-income | absolute difference (pp) (CI) | |
|---|---|---|---|---|
| Diabetes control (glycemic control) · August 2021-August 2023 | 43.0% | 52.8% | −9.8 (−17.5 to −2.1) | |
| −20−10010Difference, pp (linear scale) |
| Outcome | low-income | higher-income | Estimate | |
|---|---|---|---|---|
| Obesity prevalence | 37.3% to 42.1% | Not reported in the abstract | higher-income: not reported in the abstract | |
| Smoking | 30.2% to 22.8% | 15.0% to 10.3% | ||
| absolute change | −7.4 pp [−12.0, −2.8] | −4.7 pp [−7.1, −2.3] |
- Obesity prevalence — low-income absolute change
- +4.8 pp [95% CI, 1.1, 8.5]
- Diabetes control (glycemic control) — low-income level shift after pandemic
- −8.7 pp [−16.7, −0.6]
Diabetes control (glycemic control) · August 2021-August 2023
- Diabetes treatment did not change (no specific time point or value given)
Hypertension treatment
- low-income level shift after pandemic
- +7.8 pp [1.8, 13.8]
- income-related gap in 2009-2010 closed by August 2021-August 2023
High cholesterol treatment and control
- improved in both groups, with no income-related differences
Smoking
- remained more than two-fold higher in the low-income group
Original publication
Summarised from the published abstract; every number is checked against it