Back to Annual Meeting

Back to Annual Meeting

APHA Scientific Session and Event Listing

Patricia Carcaise-Edinboro, MS and Dolores G. Clement, Dr PH. Health Administration, Virginia Commonwealth University, 1008 East Clay Street, Grant House, P.O. Box 980203, Richmond, VA 23298-0203, 804-756-8309, pcedinboro@comcast.net

In order to improve the nation's health, it is imperative that coronary heart disease (CHD) be addressed effectively for all populations in the U.S. Evidence-based medicine strongly indicates modification of risk factors can significantly reduce mortality and morbidity associated with CHD, however disparities in the provision of CHD preventive care persists. Variables from the Medical Expenditure Panel Survey (MEPS) and Area Resource File (ARF) were used to investigate individual and community level factors on the receipt of CHD preventive care. The cross-sectional study was based on a sample of adults age 18-85 identified with CHD or CHD risk. The primary preventive care measures included blood cholesterol testing, blood pressure checks, and, diet, exercise and smoking cessation counseling. The secondary preventive measures included beta-blocker receipt after myocardial infarction (MI) and statin drug use. Using the STATA statistical program logistic regression models were used to measure the predictive nature of the individual-level independent variables (pre-disposing, enabling and need), and to examine the direct and modifying effects of the community-level factors on selected dichotomous dependent variable(s) of preventive care services. Results of the survey logistic regression analysis indicated gender and race were more consistent predictors of the receipt of CHD preventive care services than individual enabling or community characteristics. Women had a greater likelihood of receiving primary CHD preventive care services than men. The elderly (> 75 ) were less likely to receive primary CHD preventive care services as well as statin therapy for high blood cholesterol. The uninsured, rural residents, and Hispanics had a reduced likelhood of receiving primary CHD preventive care, yet Hispanics and Blacks were more likely to receive blood cholesterol testing than non-Hispanic races. Blacks had a lower likelihood of receiving beta-blocker post myocardial infarction. Community level factors did not improve the logistic regression model for the receipt of CHD preventive care, yet, when predicting the likelihood of having a usual source of care for preventive services, persons from a higher percent Hispanic or black community were less likely to have a usual source of care. Overall results indicate that disparities in CHD preventive care persist for the elderly, and racial minorities.

Learning Objectives:

• Identify sociodemographic and community factors associated with the reciept of coronary heart disease preventive care.
• List primary and secondary coronary heart disease (CHD) preventive care services.
• Recognize health disparities in the delivery of CHD preventive care.

Keywords: Prevention,

Presenting author's disclosure statement:

Not Answered