Educational Attainment and Calculated Risk of Coronary Heart Disease in the Independent State of Samoa: A Cross-Sectional Analysis
Methods: Cross-sectional surveys, anthropometric, and biological data from the 2010 Samoa Genome-Wide Association Study of Adiposity were analyzed for 1812 Samoan adults without previous cardiovascular disease or diabetes. We assessed odds ratios (OR) and 95%CI for having ≥10% risk of developing coronary heart disease (CHD) in 10 years (based on Framingham risk score) against education, using multiple logistic regression. Post-hoc logistic regression assessed odds of being eligible for LDL-lowering medications (based on Adult Treatment Panel (ATP)-III guidelines) by education level. All analyses were stratified by gender and adjusted for body mass index, occupation, and education-level of household-head.
Results: Participants who completed primary school or less had significantly increased odds of having ≥10% risk of developing CHD in 10 years compared to those with college/graduate education (aOR=4.15, 95%CI 2.04-8.46). Among males, this association remained significant (aOR 3.57, 95%CI 1.58-8.06). Females who completed primary school or less had significantly increased odds of being eligible for LDL-lowering medications, compared to those with college/graduate education (aOR 4.62, 95%CI 2.05-10.41).
Conclusion: Our findings implicate the need for policies to expand the reach of cardiovascular risk factor screenings and medications to Samoans with limited formal education. Future studies should explore structural level barriers to cardiovascular risk prevention.
Learning Areas:Assessment of individual and community needs for health education
Describe the recent epidemiological trends of cardiovascular risk factors in Samoa and discuss the implications of educational attainment in relation to cardiovascular health.
Keyword(s): Health Literacy, Chronic Disease Prevention
Qualified on the content I am responsible for because: Originally from Upstate NY, Milan is a fourth-year MD/MPH student at Brown University in Providence, RI, where she also completed her undergraduate degree. Her research and advocacy experiences have focused on promoting health equity for underserved populations in the US and abroad. She plans to continue her work in global public health as a family medicine physician-researcher.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.