The Effects of Social, Personal, and Behavioral Risk Factors and PM 2.5  on Cardio-Metabolic Disparities in a Cohort of Community Health Center Patients

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

(1) Background: Cardio-metabolic diseases (CMD), including cardiovascular disease, stroke, and diabetes, have numerous common individual and environmental risk factors. Yet, few studies to date have considered how these multiple risk factors together affect CMD disparities between Blacks and Whites. (2) Methods: We linked daily fine particulate matter (PM _2.5) measures with survey responses of participants in the Southern Community Cohort Study (SCCS). Generalized linear mixed modeling (GLMM) was used to estimate the relationship between CMD risk and social-demographic characteristics, behavioral and personal risk factors, and exposure levels of PM _2.5. (3) Results: The study resulted in four key findings: (1) PM _2.5 concentration level was significantly associated with reported CMD, with risk rising by 2.6% for each µg/m ³ increase in PM _2.5; (2) race did not predict CMD risk when clinical, lifestyle, and environmental risk factors were accounted for; (3) a significant variation of CMD risk was found among participants across states; and (4) multiple personal, clinical, and social-demographic and environmental risk factors played a role in predicting CMD occurrence. (4) Conclusions: Disparities in CMD risk among low social status populations reflect the complex interactions of exposures and cumulative risks for CMD contributed by different personal and environmental factors from natural, built, and social environments.

Related collections

Most cited references 88

Record: found
Abstract: found
Article: not found

Chronic kidney disease and mortality risk: a systematic review.

Marcello Tonelli, Natasha Wiebe, Bruce Culleton … (2006)

Current guidelines identify people with chronic kidney disease (CKD) as being at high risk for cardiovascular and all-cause mortality. Because as many as 19 million Americans may have CKD, a comprehensive summary of this risk would be potentially useful for planning public health policy. A systematic review of the association between non-dialysis-dependent CKD and the risk for all-cause and cardiovascular mortality was conducted. Patient- and study-related characteristics that influenced the magnitude of these associations also were investigated. MEDLINE and EMBASE databases were searched, and reference lists through December 2004 were consulted. Authors of 10 primary studies provided additional data. Cohort studies or cohort analyses of randomized, controlled trials that compared mortality between those with and without chronically reduced kidney function were included. Studies were excluded from review when participants were followed for < 1 yr or had ESRD. Two reviewers independently extracted data on study setting, quality, participant and renal function characteristics, and outcomes. Thirty-nine studies that followed a total of 1,371,990 participants were reviewed. The unadjusted relative risk for mortality in participants with reduced kidney function compared with those without ranged from 0.94 to 5.0 and was significantly more than 1.0 in 93% of cohorts. Among the 16 studies that provided suitable data, the absolute risk for death increased exponentially with decreasing renal function. Fourteen cohorts described the risk for mortality from reduced kidney function, after adjustment for other established risk factors. Although adjusted relative hazards were consistently lower than unadjusted relative risks (median reduction 17%), they remained significantly more than 1.0 in 71% of cohorts. This review supports current guidelines that identify individuals with CKD as being at high risk for cardiovascular mortality. Determining which interventions best offset this risk remains a health priority.

0 comments Cited 508 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Socioeconomic disparities in health in the United States: what the patterns tell us.

Paula Braveman, Catherine Cubbin, Susan Egerter … (2010)

We aimed to describe socioeconomic disparities in the United States across multiple health indicators and socioeconomic groups. Using recent national data on 5 child (infant mortality, health status, activity limitation, healthy eating, sedentary adolescents) and 6 adult (life expectancy, health status, activity limitation, heart disease, diabetes, obesity) health indicators, we examined indicator rates across multiple income or education categories, overall and within racial/ethnic groups. Those with the lowest income and who were least educated were consistently least healthy, but for most indicators, even groups with intermediate income and education levels were less healthy than the wealthiest and most educated. Gradient patterns were seen often among non-Hispanic Blacks and Whites but less consistently among Hispanics. Health in the United States is often, though not invariably, patterned strongly along both socioeconomic and racial/ethnic lines, suggesting links between hierarchies of social advantage and health. Worse health among the most socially disadvantaged argues for policies prioritizing those groups, but pervasive gradient patterns also indicate a need to address a wider socioeconomic spectrum-which may help garner political support. Routine health reporting should examine socioeconomic and racial/ethnic disparity patterns, jointly and separately.

0 comments Cited 387 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Lead Exposure and Cardiovascular Disease—A Systematic Review

Ana Navas-Acien, Eliseo Guallar, Ellen Silbergeld … (2006)

Objective This systematic review evaluates the evidence on the association between lead exposure and cardiovascular end points in human populations. Methods We reviewed all observational studies from database searches and citations regarding lead and cardiovascular end points. Results A positive association of lead exposure with blood pressure has been identified in numerous studies in different settings, including prospective studies and in relatively homogeneous socioeconomic status groups. Several studies have identified a dose–response relationship. Although the magnitude of this association is modest, it may be underestimated by measurement error. The hypertensive effects of lead have been confirmed in experimental models. Beyond hypertension, studies in general populations have identified a positive association of lead exposure with clinical cardiovascular outcomes (cardiovascular, coronary heart disease, and stroke mortality; and peripheral arterial disease), but the number of studies is small. In some studies these associations were observed at blood lead levels < 5 μg/dL. Conclusions We conclude that the evidence is sufficient to infer a causal relationship of lead exposure with hypertension. We conclude that the evidence is suggestive but not sufficient to infer a causal relationship of lead exposure with clinical cardiovascular outcomes. There is also suggestive but insufficient evidence to infer a causal relationship of lead exposure with heart rate variability. Public Health Implications These findings have immediate public health implications. Current occupational safety standards for blood lead must be lowered and a criterion for screening elevated lead exposure needs to be established in adults. Risk assessment and economic analyses of lead exposure impact must include the cardiovascular effects of lead. Finally, regulatory and public health interventions must be developed and implemented to further prevent and reduce lead exposure.

0 comments Cited 261 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): Int J Environ Res Public Health

Journal ID (iso-abbrev): Int J Environ Res Public Health

Journal ID (publisher-id): ijerph

Title: International Journal of Environmental Research and Public Health

Publisher: MDPI

ISSN (Print): 1661-7827

ISSN (Electronic): 1660-4601

Publication date (Electronic): 19 May 2020

Publication date (Print): May 2020

Volume: 17

Issue: 10

Electronic Location Identifier: 3561

Affiliations

[1 ]Department of Family and Community Medicine, Meharry Medical College, Nashville, TN 37208, USA; wim@ 123456mmc.edu (W.I.); pmatthews-juarez@ 123456mmc.edu (P.M.-J.)

[2 ]School of Graduate Studies and Research, Meharry Medical College, Nashville, TN 37208, USA; mtabatabai@ 123456mmc.edu

[3 ]RWJF Professor, Department of Family & Community Medicine AND Economics, University of New Mexico, Albuquerque, NM 87131, USA; rovaldez@ 123456aol.com

[4 ]Department of Environmental Health Sciences, College of Public Health, Ohio State University, Columbus, OH 43210, USA; dhood@ 123456cph.osu.edu

[5 ]Department of Family Medicine, University of Texas Medical Branch, Galveston, TX 77555, USA; cpmouton@ 123456UTMB.edu

[6 ]Department of Sociology, Ohio State University, Columbus, OH 43210, USA; colen.3@ 123456osu.edu

[7 ]Universities Space Research Association, NASA Marshall Space Flight Center, Huntsville, AL 35805, USA; mohammad.alhamdan@ 123456nasa.gov

[8 ]Department of Environmental Health Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA; mlichtve@ 123456tulane.edu

[9 ]Department of Biostatistics, Xavier University, Cincinnati, OH 45207, USA; dsarpong@ 123456xula.edu

[10 ]Department of Biochemistry, Cancer Biology, Neuroscience & Pharmacology, Meharry Medical College, Nashville, TN 37208, USA; aramesh@ 123456mmc.edu

[11 ]Department of Electrical Engineering and Computer Science, University of Tennessee, Knoxville, TN 37996, USA; Langston@ 123456eecs.utk.edu (M.A.L.); cphill25@ 123456eecs.utk.edu (C.A.P.)

[12 ]National Institute for Computational Sciences, University of Tennessee, Knoxville, TN 37996, USA; grogers3@ 123456utk.edu

[13 ]Department of Environmental Health, Risk Science Center, University of Cincinnati, Cincinnati, OH 45221, USA; reichajf@ 123456uc.edu

[14 ]Division of Outcomes and Translational Sciences, College of Pharmacy, Ohio State University, Columbus, OH 43210, USA; donneyong.1@ 123456osu.edu

[15 ]Center for Population-based Research, Vanderbilt University, Nashville, TN 37235, USA; william.j.blot@ 123456Vanderbilt.Edu

Author notes

[* ]Correspondence: pjuarez@ 123456mmc.edu

Author information

Paul D. Juarez https://orcid.org/0000-0002-3120-7333

Mohammad Tabatabai https://orcid.org/0000-0002-1631-5264

Michael A. Langston https://orcid.org/0000-0001-5945-5796

Article

Publisher ID: ijerph-17-03561

DOI: 10.3390/ijerph17103561

PMC ID: 7277630

PubMed ID: 32438697

SO-VID: 45a5e434-1c75-488f-90f6-e1105fca76d8

License:

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

The Effects of Social, Personal, and Behavioral Risk Factors and PM _2.5 on Cardio-Metabolic Disparities in a Cohort of Community Health Center Patients

Read this article at

Abstract

Related collections

Karger: Digital Health

Most cited references 88

Chronic kidney disease and mortality risk: a systematic review.

Socioeconomic disparities in health in the United States: what the patterns tell us.

Lead Exposure and Cardiovascular Disease—A Systematic Review

Author and article information

Journal

Affiliations

Author notes

Author information

Article

History

Categories

Comments

Comment on this article

Similar content 208

Cited by 9

Most referenced authors 2,129