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APHA Scientific Session and Event Listing

Recorded presentation

Tina L. Harralson, PhD and Renee E. Walker, MPH. Center for Urban Health Policy and Research, Albert Einstein Healthcare Network, One Penn Blvd. 4442 Wister Tower, Philadelphia, PA 19144, 215-951-8137, harralsont@einstein.edu

It is recommended that persons seek emergency medical attention for the symptoms of acute myocardial infarction (AMI) within one hour of onset. Delay in seeking AMI treatment is of particular clinical importance among older, African American, and lower income persons who tend to have longer delays and poorer clinical outcomes. Studies have examined demographic barriers to seeking treatment for AMI symptoms, but little research has been conducted examining potential psychosocial barriers. The purpose of this study was to examine demographic and psychosocial barriers among a mainly African American patient population (Mean age 55 years) admitted to a large, urban hospital with the symptoms of AMI. Patients were interviewed regarding their experiences seeking medical attention for AMI and reasons for delay. In addition, they were asked to complete the Center for Epidemiological Studies depression scale (CES-D) and the Health Complaints Scale (HCS) for coronary heart disease. The HCS contains two subscales: cognitive complaints (e.g., the belief that one has a serious illness) and somatic complaints (e.g., feeling exhausted without reason). Preliminary analyses of this study indicate a mean delay time of 24 hours for seeking emergency medical attention for AMI symptoms (Median= 4.5 hours). Among persons who delayed > 1 hour, 53% had depressive symptomatology associated with major depression (CES-D scores > 16). Persons who delay > 1 hour also had fewer cognitive and somatic complaints compared to persons who sought emergency medical attention in < 1 hour. Implications for program development to reduce disparities in delay will be discussed.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• describe barriers to seeking emergency medical treatment for AMI;
• discuss gender and ethnic differences, and 3)discuss clinical implications.

Keywords: African American, Barriers to Care

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation