Socioeconomic Characteristics Are Major Contributors to Ethnic Differences in Health Status in Obstructive Lung Disease: An Analysis of the National Health and Nutrition Examination Survey 2007-2010
Understanding ethnic differences in health status (HS) could help in designing culturally appropriate interventions. We hypothesized that racial and ethnic differences exist in HS between non-Hispanic whites and Mexican Americans with obstructive lung disease (OLD) and that these differences are med...
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| Veröffentlicht in: | Chest 2015-07, Vol.148 (1), p.151-158 |
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| creator | Martinez, Carlos H Mannino, David M Curtis, Jeffrey L Han, MeiLan K Diaz, Alejandro A |
| description | Understanding ethnic differences in health status (HS) could help in designing culturally appropriate interventions. We hypothesized that racial and ethnic differences exist in HS between non-Hispanic whites and Mexican Americans with obstructive lung disease (OLD) and that these differences are mediated by socioeconomic factors.
We analyzed 826 US adults aged ≥ 30 years self-identified as Mexican American or non-Hispanic white with spirometry-confirmed OLD (FEV₁/FVC < 0.7) who participated in the National Health and Nutrition Examination Survey 2007-2010. We assessed associations between Mexican American ethnicity and self-reported HS using logistic regression models adjusted for demographics, smoking status, number of comorbidities, limitations for work, and lung function and tested the contribution of education and health-care access to ethnic differences in HS.
Among Mexican Americans with OLD, worse (fair or poor) HS was more prevalent than among non-Hispanic whites (weighted percentage [SE], 46.6% [5.0] vs 15.2% [1.6]; P < .001). In bivariate analysis, socioeconomic characteristics were associated with lower odds of reporting poor HS (high school graduation: OR, 0.24 [95% CI, 0.10-0.40]; access to health care: OR, 0.50 [95% CI, 0.30-0.80]). In fully adjusted models, a strong association was found between Mexican American ethnicity (vs non-Hispanic white) and fair or poor HS (OR, 7.52; 95% CI, 4.43-12.78; P < .001). Higher education and access to health care contributed to lowering the Mexican American ethnicity odds of fair or poor HS by 47% and 16%, respectively, and together, they contributed 55% to reducing the differences in HS with non-Hispanic whites.
Mexican Americans with OLD report poorer overall HS than non-Hispanic whites, and education and access to health care are large contributors to the difference. |
| doi_str_mv | 10.1378/chest.14-1814 |
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We analyzed 826 US adults aged ≥ 30 years self-identified as Mexican American or non-Hispanic white with spirometry-confirmed OLD (FEV₁/FVC < 0.7) who participated in the National Health and Nutrition Examination Survey 2007-2010. We assessed associations between Mexican American ethnicity and self-reported HS using logistic regression models adjusted for demographics, smoking status, number of comorbidities, limitations for work, and lung function and tested the contribution of education and health-care access to ethnic differences in HS.
Among Mexican Americans with OLD, worse (fair or poor) HS was more prevalent than among non-Hispanic whites (weighted percentage [SE], 46.6% [5.0] vs 15.2% [1.6]; P < .001). In bivariate analysis, socioeconomic characteristics were associated with lower odds of reporting poor HS (high school graduation: OR, 0.24 [95% CI, 0.10-0.40]; access to health care: OR, 0.50 [95% CI, 0.30-0.80]). In fully adjusted models, a strong association was found between Mexican American ethnicity (vs non-Hispanic white) and fair or poor HS (OR, 7.52; 95% CI, 4.43-12.78; P < .001). Higher education and access to health care contributed to lowering the Mexican American ethnicity odds of fair or poor HS by 47% and 16%, respectively, and together, they contributed 55% to reducing the differences in HS with non-Hispanic whites.
Mexican Americans with OLD report poorer overall HS than non-Hispanic whites, and education and access to health care are large contributors to the difference.</description><identifier>ISSN: 0012-3692</identifier><identifier>EISSN: 1931-3543</identifier><identifier>DOI: 10.1378/chest.14-1814</identifier><identifier>PMID: 25633478</identifier><language>eng</language><publisher>United States: American College of Chest Physicians</publisher><subject>Adult ; Aged ; Cross-Sectional Studies ; European Continental Ancestry Group ; Female ; Forced Expiratory Volume ; Health Status Disparities ; Healthcare Disparities - ethnology ; Humans ; Logistic Models ; Lung Diseases, Obstructive - complications ; Lung Diseases, Obstructive - diagnosis ; Lung Diseases, Obstructive - ethnology ; Male ; Mexican Americans ; Middle Aged ; Nutrition Surveys ; Original Research ; Socioeconomic Factors ; Spirometry ; United States - epidemiology</subject><ispartof>Chest, 2015-07, Vol.148 (1), p.151-158</ispartof><rights>2015 AMERICAN COLLEGE OF CHEST PHYSICIANS 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25633478$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Martinez, Carlos H</creatorcontrib><creatorcontrib>Mannino, David M</creatorcontrib><creatorcontrib>Curtis, Jeffrey L</creatorcontrib><creatorcontrib>Han, MeiLan K</creatorcontrib><creatorcontrib>Diaz, Alejandro A</creatorcontrib><title>Socioeconomic Characteristics Are Major Contributors to Ethnic Differences in Health Status in Obstructive Lung Disease: An Analysis of the National Health and Nutrition Examination Survey 2007-2010</title><title>Chest</title><addtitle>Chest</addtitle><description>Understanding ethnic differences in health status (HS) could help in designing culturally appropriate interventions. We hypothesized that racial and ethnic differences exist in HS between non-Hispanic whites and Mexican Americans with obstructive lung disease (OLD) and that these differences are mediated by socioeconomic factors.
We analyzed 826 US adults aged ≥ 30 years self-identified as Mexican American or non-Hispanic white with spirometry-confirmed OLD (FEV₁/FVC < 0.7) who participated in the National Health and Nutrition Examination Survey 2007-2010. We assessed associations between Mexican American ethnicity and self-reported HS using logistic regression models adjusted for demographics, smoking status, number of comorbidities, limitations for work, and lung function and tested the contribution of education and health-care access to ethnic differences in HS.
Among Mexican Americans with OLD, worse (fair or poor) HS was more prevalent than among non-Hispanic whites (weighted percentage [SE], 46.6% [5.0] vs 15.2% [1.6]; P < .001). In bivariate analysis, socioeconomic characteristics were associated with lower odds of reporting poor HS (high school graduation: OR, 0.24 [95% CI, 0.10-0.40]; access to health care: OR, 0.50 [95% CI, 0.30-0.80]). In fully adjusted models, a strong association was found between Mexican American ethnicity (vs non-Hispanic white) and fair or poor HS (OR, 7.52; 95% CI, 4.43-12.78; P < .001). Higher education and access to health care contributed to lowering the Mexican American ethnicity odds of fair or poor HS by 47% and 16%, respectively, and together, they contributed 55% to reducing the differences in HS with non-Hispanic whites.
Mexican Americans with OLD report poorer overall HS than non-Hispanic whites, and education and access to health care are large contributors to the difference.</description><subject>Adult</subject><subject>Aged</subject><subject>Cross-Sectional Studies</subject><subject>European Continental Ancestry Group</subject><subject>Female</subject><subject>Forced Expiratory Volume</subject><subject>Health Status Disparities</subject><subject>Healthcare Disparities - ethnology</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Lung Diseases, Obstructive - complications</subject><subject>Lung Diseases, Obstructive - diagnosis</subject><subject>Lung Diseases, Obstructive - ethnology</subject><subject>Male</subject><subject>Mexican Americans</subject><subject>Middle Aged</subject><subject>Nutrition Surveys</subject><subject>Original Research</subject><subject>Socioeconomic Factors</subject><subject>Spirometry</subject><subject>United States - epidemiology</subject><issn>0012-3692</issn><issn>1931-3543</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVUUtvEzEQthCIhsKRK_KRyxa_4l1zQIrSQJFCewicV7PObNfVrh1sb0T-IL8LU1oE0kij-eZ7SDOEvObsgsu6eWcHTPmCq4o3XD0hC24kr-RSyadkwRgXldRGnJEXKd2xMnOjn5MzsdRSqrpZkJ-7YF1AG3yYnKXrASLYjNGl7Gyiq4j0C9yFSNfB5-i6OYeYaA50kwdfBJeu7zGit5io8_QKYcwD3WXI8z1w06UcZ5vdEel29rdFkBASvqcrXwrGU3KJhp7mAek1ZBcK9mgDfk-v5xL7G6abHzA5f0-huzke8UQFY3UlGGcvybMexoSvHvo5-fZx83V9VW1vPn1er7bVQWidKzCKyf1SY2ekwkZbraRBCxqMVaLpamG4QNE1VjPUTWPBamB71mFv-pqhPCcf_vge5m7CvcVyFBjbQ3QTxFMbwLX_b7wb2ttwbJUysql5MXj7YBDD97m8rp1csjiO4DHMqeXaKKO5WMpCffNv1t-Qx-fJXxDqoJw</recordid><startdate>20150701</startdate><enddate>20150701</enddate><creator>Martinez, Carlos H</creator><creator>Mannino, David M</creator><creator>Curtis, Jeffrey L</creator><creator>Han, MeiLan K</creator><creator>Diaz, Alejandro A</creator><general>American College of Chest Physicians</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20150701</creationdate><title>Socioeconomic Characteristics Are Major Contributors to Ethnic Differences in Health Status in Obstructive Lung Disease: An Analysis of the National Health and Nutrition Examination Survey 2007-2010</title><author>Martinez, Carlos H ; Mannino, David M ; Curtis, Jeffrey L ; Han, MeiLan K ; Diaz, Alejandro A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p266t-a9403d56eb934e86c6439eca6a9c428b72912e2b8c60e688cac6a0d0bef9f70e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Cross-Sectional Studies</topic><topic>European Continental Ancestry Group</topic><topic>Female</topic><topic>Forced Expiratory Volume</topic><topic>Health Status Disparities</topic><topic>Healthcare Disparities - ethnology</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Lung Diseases, Obstructive - complications</topic><topic>Lung Diseases, Obstructive - diagnosis</topic><topic>Lung Diseases, Obstructive - ethnology</topic><topic>Male</topic><topic>Mexican Americans</topic><topic>Middle Aged</topic><topic>Nutrition Surveys</topic><topic>Original Research</topic><topic>Socioeconomic Factors</topic><topic>Spirometry</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Martinez, Carlos H</creatorcontrib><creatorcontrib>Mannino, David M</creatorcontrib><creatorcontrib>Curtis, Jeffrey L</creatorcontrib><creatorcontrib>Han, MeiLan K</creatorcontrib><creatorcontrib>Diaz, Alejandro A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Chest</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Martinez, Carlos H</au><au>Mannino, David M</au><au>Curtis, Jeffrey L</au><au>Han, MeiLan K</au><au>Diaz, Alejandro A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Socioeconomic Characteristics Are Major Contributors to Ethnic Differences in Health Status in Obstructive Lung Disease: An Analysis of the National Health and Nutrition Examination Survey 2007-2010</atitle><jtitle>Chest</jtitle><addtitle>Chest</addtitle><date>2015-07-01</date><risdate>2015</risdate><volume>148</volume><issue>1</issue><spage>151</spage><epage>158</epage><pages>151-158</pages><issn>0012-3692</issn><eissn>1931-3543</eissn><abstract>Understanding ethnic differences in health status (HS) could help in designing culturally appropriate interventions. We hypothesized that racial and ethnic differences exist in HS between non-Hispanic whites and Mexican Americans with obstructive lung disease (OLD) and that these differences are mediated by socioeconomic factors.
We analyzed 826 US adults aged ≥ 30 years self-identified as Mexican American or non-Hispanic white with spirometry-confirmed OLD (FEV₁/FVC < 0.7) who participated in the National Health and Nutrition Examination Survey 2007-2010. We assessed associations between Mexican American ethnicity and self-reported HS using logistic regression models adjusted for demographics, smoking status, number of comorbidities, limitations for work, and lung function and tested the contribution of education and health-care access to ethnic differences in HS.
Among Mexican Americans with OLD, worse (fair or poor) HS was more prevalent than among non-Hispanic whites (weighted percentage [SE], 46.6% [5.0] vs 15.2% [1.6]; P < .001). In bivariate analysis, socioeconomic characteristics were associated with lower odds of reporting poor HS (high school graduation: OR, 0.24 [95% CI, 0.10-0.40]; access to health care: OR, 0.50 [95% CI, 0.30-0.80]). In fully adjusted models, a strong association was found between Mexican American ethnicity (vs non-Hispanic white) and fair or poor HS (OR, 7.52; 95% CI, 4.43-12.78; P < .001). Higher education and access to health care contributed to lowering the Mexican American ethnicity odds of fair or poor HS by 47% and 16%, respectively, and together, they contributed 55% to reducing the differences in HS with non-Hispanic whites.
Mexican Americans with OLD report poorer overall HS than non-Hispanic whites, and education and access to health care are large contributors to the difference.</abstract><cop>United States</cop><pub>American College of Chest Physicians</pub><pmid>25633478</pmid><doi>10.1378/chest.14-1814</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Cross-Sectional Studies European Continental Ancestry Group Female Forced Expiratory Volume Health Status Disparities Healthcare Disparities - ethnology Humans Logistic Models Lung Diseases, Obstructive - complications Lung Diseases, Obstructive - diagnosis Lung Diseases, Obstructive - ethnology Male Mexican Americans Middle Aged Nutrition Surveys Original Research Socioeconomic Factors Spirometry United States - epidemiology |
| title | Socioeconomic Characteristics Are Major Contributors to Ethnic Differences in Health Status in Obstructive Lung Disease: An Analysis of the National Health and Nutrition Examination Survey 2007-2010 |
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