Social, Behavioral, and Metabolic Risk Factors and Racial Disparities in Cardiovascular Disease Mortality in U.S. Adults : An Observational Study
Authors' conclusion
The Black-White difference in CVD mortality diminished after adjustment for behavioral and metabolic risk factors and completely dissipated with adjustment for social determinants of health in the U.S. population.
Study context
- Population
- US adults aged ≥20 years, NHANES 1999 to 20182,589 cardiovascular disease (CVD) deaths
- Participants
- 50,808 adults
- Exposure
- Black vs White participants (and Hispanic, other race groups), with adjustment for social, behavioral and metabolic risk factors
- Outcome
- CVD mortality (National Death Index linkage)
- Follow-up
- Through 2019; average 9.4 years
Methodological detailsnationally representative sample, Causal contributions of risk factors to disparities could not be established
- Nationally representative sample
- Causal contributions of risk factors to disparities could not be established
Main finding
As reported in the abstract
CVD mortality, age- and sex-standardized rate · average 9.4 years
Black vs WhiteHazard ratio (95% CI)
Before adjustment for risk factors
1.54(1.34–1.77)
Adjusted for metabolic risk factors
1.34(1.16–1.55)
Adjusted for behavioral risk factors
1.31(1.15–1.50)
Adjusted for social risk factors
1.04(0.90–1.21)
Observational data: associations, not effects.
Further findings
Risk factors for CVD death (multiple Cox regression, all factors adjusted simultaneously)
- Social (unemployment, low family income, food insecurity, lack of home ownership, unpartnered status), behavioral (current smoking, lack of leisure-time physical activity, sleep <6 or >8 h/d) and metabolic (obesity, hypertension, DM) risk factors associated with significantly higher risk of CVD death
Original publication
Social, Behavioral, and Metabolic Risk Factors and Racial Disparities in Cardiovascular Disease Mortality in U.S. Adults : An Observational Study. Ann Intern Med. Published 15 August 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →