American Heart Association’s Ideal Cardiovascular Health Metrics in Under-Represented Asian Americans
The American Heart Association’s ideal cardiovascular health score is based on 7 cardiovascular health metrics to measure progress toward their Impact Goal of reducing cardiovascular disease by 20 % before 2020. This study applied this construct to assess cardiovascular health in a sample of Asian A...
Gespeichert in:
Veröffentlicht in: | Journal of community health 2016-12, Vol.41 (6), p.1282-1289 |
---|---|
Hauptverfasser: | , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 1289 |
---|---|
container_issue | 6 |
container_start_page | 1282 |
container_title | Journal of community health |
container_volume | 41 |
creator | Patterson, Freda Zhang, Guo Davey, Adam Tan, Yin Ma, Grace X. |
description | The American Heart Association’s ideal cardiovascular health score is based on 7 cardiovascular health metrics to measure progress toward their Impact Goal of reducing cardiovascular disease by 20 % before 2020. This study applied this construct to assess cardiovascular health in a sample of Asian Americans. Convenience sampling methods were used to enroll self-identified Asian American’s over the age of 18 years who were attending community health fairs across the greater Philadelphia and urban areas of New Jersey. The heart health metrics of tobacco use, body mass index, physical activity, diet, blood pressure, and glucose were measured. In the greater sample (N = 541), 82 % were female, the mean age was 65.1 (SD = 15.5) years, 45 % were Vietnamese, 38 % were Chinese and 17 % were Korean. Prevalence of ideal heart health for the metrics of tobacco use (95 %) was high. Only 19.4 % achieved ideal levels of physical activity, 35.1 % for BMI, 28.9 % for glucose and 66 % for blood pressure. Dietary intake was ideal for 20.7 % of the sample. More years since migration and Korean race trended toward having a higher prevalence of poor health in some metrics. Most Asian Americans are not achieving ideal cardiovascular health for several of the metrics evaluated, with those residing in the United States for more than 13 years and Korean Americans being higherrisk groups. Targeted community based intervention approaches to improving and monitoring heart health in Asian American, and Asian American subgroups, are needed. |
doi_str_mv | 10.1007/s10900-016-0217-3 |
format | Article |
fullrecord | <record><control><sourceid>jstor_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5083159</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><jstor_id>48716484</jstor_id><sourcerecordid>48716484</sourcerecordid><originalsourceid>FETCH-LOGICAL-c525t-bfec17bdb282b511d31a05ae33c9788ad07e8d0ba97dee5c3f5035b364f6300f3</originalsourceid><addsrcrecordid>eNqFkc1u1DAUhS0EokPhAViAIrFhE7i2459skEajQisVISG6thz7ZupRJhnspBI7XoPX65PgKO2osICVF_ec71zfQ8hLCu8ogHqfKNQAJVBZAqOq5I_IigrFSy4pPCYrgLoqBa3ECXmW0g4AKCj5lJwwxSXXrFqR7XqPMTjbF-do41isUxpcsGMY-tufv1Jx4dF2xcZGH4Ybm9zU2ThLu_G6-IxjtqYi9MVV7zGWX_EQMWE_os-gkKH39PScPGltl_DF3XtKrj6efducl5dfPl1s1pelE0yMZdOio6rxDdOsEZR6Ti0Ii5y7WmltPSjUHhpbK48oHG8FcNFwWbWSA7T8lHxYuIep2aN3eZloO3OIYW_jDzPYYP6c9OHabIcbI0BzKuoMeHsHiMP3CdNo9iE57Drb4zAlQzVXOUnlM_9fyqSivNYsS9_8Jd0NU-zzJWYgB1ZJOWfTReXikFLE9rg3BTM3bpbGTW7czI0bnj2vH3746LivOAvYIkh51G8xPoj-B_XVYtqlcYhHaKUVlZWu-G98sMGX</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1833024669</pqid></control><display><type>article</type><title>American Heart Association’s Ideal Cardiovascular Health Metrics in Under-Represented Asian Americans</title><source>MEDLINE</source><source>SpringerNature Journals</source><source>JSTOR Archive Collection A-Z Listing</source><source>EBSCOhost Education Source</source><creator>Patterson, Freda ; Zhang, Guo ; Davey, Adam ; Tan, Yin ; Ma, Grace X.</creator><creatorcontrib>Patterson, Freda ; Zhang, Guo ; Davey, Adam ; Tan, Yin ; Ma, Grace X.</creatorcontrib><description>The American Heart Association’s ideal cardiovascular health score is based on 7 cardiovascular health metrics to measure progress toward their Impact Goal of reducing cardiovascular disease by 20 % before 2020. This study applied this construct to assess cardiovascular health in a sample of Asian Americans. Convenience sampling methods were used to enroll self-identified Asian American’s over the age of 18 years who were attending community health fairs across the greater Philadelphia and urban areas of New Jersey. The heart health metrics of tobacco use, body mass index, physical activity, diet, blood pressure, and glucose were measured. In the greater sample (N = 541), 82 % were female, the mean age was 65.1 (SD = 15.5) years, 45 % were Vietnamese, 38 % were Chinese and 17 % were Korean. Prevalence of ideal heart health for the metrics of tobacco use (95 %) was high. Only 19.4 % achieved ideal levels of physical activity, 35.1 % for BMI, 28.9 % for glucose and 66 % for blood pressure. Dietary intake was ideal for 20.7 % of the sample. More years since migration and Korean race trended toward having a higher prevalence of poor health in some metrics. Most Asian Americans are not achieving ideal cardiovascular health for several of the metrics evaluated, with those residing in the United States for more than 13 years and Korean Americans being higherrisk groups. Targeted community based intervention approaches to improving and monitoring heart health in Asian American, and Asian American subgroups, are needed.</description><identifier>ISSN: 0094-5145</identifier><identifier>EISSN: 1573-3610</identifier><identifier>DOI: 10.1007/s10900-016-0217-3</identifier><identifier>PMID: 27363824</identifier><identifier>CODEN: JCMHBR</identifier><language>eng</language><publisher>New York: Springer Science + Business Media</publisher><subject>Aged ; American Heart Association ; Asian Americans ; Blood pressure ; Body Composition ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - ethnology ; Community and Environmental Psychology ; Diet ; Ethics ; Female ; Health Promotion and Disease Prevention ; Health Status ; Heart Disorders ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Migration ; New Jersey - epidemiology ; ORIGINAL PAPER ; Philadelphia - epidemiology ; Sampling methods ; Studies ; United States ; Urban areas</subject><ispartof>Journal of community health, 2016-12, Vol.41 (6), p.1282-1289</ispartof><rights>Springer Science+Business Media New York 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c525t-bfec17bdb282b511d31a05ae33c9788ad07e8d0ba97dee5c3f5035b364f6300f3</citedby><cites>FETCH-LOGICAL-c525t-bfec17bdb282b511d31a05ae33c9788ad07e8d0ba97dee5c3f5035b364f6300f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/48716484$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/48716484$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>230,314,780,784,803,885,27924,27925,41488,42557,51319,58017,58250</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27363824$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Patterson, Freda</creatorcontrib><creatorcontrib>Zhang, Guo</creatorcontrib><creatorcontrib>Davey, Adam</creatorcontrib><creatorcontrib>Tan, Yin</creatorcontrib><creatorcontrib>Ma, Grace X.</creatorcontrib><title>American Heart Association’s Ideal Cardiovascular Health Metrics in Under-Represented Asian Americans</title><title>Journal of community health</title><addtitle>J Community Health</addtitle><addtitle>J Community Health</addtitle><description>The American Heart Association’s ideal cardiovascular health score is based on 7 cardiovascular health metrics to measure progress toward their Impact Goal of reducing cardiovascular disease by 20 % before 2020. This study applied this construct to assess cardiovascular health in a sample of Asian Americans. Convenience sampling methods were used to enroll self-identified Asian American’s over the age of 18 years who were attending community health fairs across the greater Philadelphia and urban areas of New Jersey. The heart health metrics of tobacco use, body mass index, physical activity, diet, blood pressure, and glucose were measured. In the greater sample (N = 541), 82 % were female, the mean age was 65.1 (SD = 15.5) years, 45 % were Vietnamese, 38 % were Chinese and 17 % were Korean. Prevalence of ideal heart health for the metrics of tobacco use (95 %) was high. Only 19.4 % achieved ideal levels of physical activity, 35.1 % for BMI, 28.9 % for glucose and 66 % for blood pressure. Dietary intake was ideal for 20.7 % of the sample. More years since migration and Korean race trended toward having a higher prevalence of poor health in some metrics. Most Asian Americans are not achieving ideal cardiovascular health for several of the metrics evaluated, with those residing in the United States for more than 13 years and Korean Americans being higherrisk groups. Targeted community based intervention approaches to improving and monitoring heart health in Asian American, and Asian American subgroups, are needed.</description><subject>Aged</subject><subject>American Heart Association</subject><subject>Asian Americans</subject><subject>Blood pressure</subject><subject>Body Composition</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - ethnology</subject><subject>Community and Environmental Psychology</subject><subject>Diet</subject><subject>Ethics</subject><subject>Female</subject><subject>Health Promotion and Disease Prevention</subject><subject>Health Status</subject><subject>Heart Disorders</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Migration</subject><subject>New Jersey - epidemiology</subject><subject>ORIGINAL PAPER</subject><subject>Philadelphia - epidemiology</subject><subject>Sampling methods</subject><subject>Studies</subject><subject>United States</subject><subject>Urban areas</subject><issn>0094-5145</issn><issn>1573-3610</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkc1u1DAUhS0EokPhAViAIrFhE7i2459skEajQisVISG6thz7ZupRJhnspBI7XoPX65PgKO2osICVF_ec71zfQ8hLCu8ogHqfKNQAJVBZAqOq5I_IigrFSy4pPCYrgLoqBa3ECXmW0g4AKCj5lJwwxSXXrFqR7XqPMTjbF-do41isUxpcsGMY-tufv1Jx4dF2xcZGH4Ybm9zU2ThLu_G6-IxjtqYi9MVV7zGWX_EQMWE_os-gkKH39PScPGltl_DF3XtKrj6efducl5dfPl1s1pelE0yMZdOio6rxDdOsEZR6Ti0Ii5y7WmltPSjUHhpbK48oHG8FcNFwWbWSA7T8lHxYuIep2aN3eZloO3OIYW_jDzPYYP6c9OHabIcbI0BzKuoMeHsHiMP3CdNo9iE57Drb4zAlQzVXOUnlM_9fyqSivNYsS9_8Jd0NU-zzJWYgB1ZJOWfTReXikFLE9rg3BTM3bpbGTW7czI0bnj2vH3746LivOAvYIkh51G8xPoj-B_XVYtqlcYhHaKUVlZWu-G98sMGX</recordid><startdate>20161201</startdate><enddate>20161201</enddate><creator>Patterson, Freda</creator><creator>Zhang, Guo</creator><creator>Davey, Adam</creator><creator>Tan, Yin</creator><creator>Ma, Grace X.</creator><general>Springer Science + Business Media</general><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7RV</scope><scope>7T2</scope><scope>7X7</scope><scope>7XB</scope><scope>88B</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>88J</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>CJNVE</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0P</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M2R</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PATMY</scope><scope>PQEDU</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>PYCSY</scope><scope>Q9U</scope><scope>7X8</scope><scope>7U2</scope><scope>5PM</scope></search><sort><creationdate>20161201</creationdate><title>American Heart Association’s Ideal Cardiovascular Health Metrics in Under-Represented Asian Americans</title><author>Patterson, Freda ; Zhang, Guo ; Davey, Adam ; Tan, Yin ; Ma, Grace X.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c525t-bfec17bdb282b511d31a05ae33c9788ad07e8d0ba97dee5c3f5035b364f6300f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>American Heart Association</topic><topic>Asian Americans</topic><topic>Blood pressure</topic><topic>Body Composition</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Cardiovascular Diseases - ethnology</topic><topic>Community and Environmental Psychology</topic><topic>Diet</topic><topic>Ethics</topic><topic>Female</topic><topic>Health Promotion and Disease Prevention</topic><topic>Health Status</topic><topic>Heart Disorders</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Migration</topic><topic>New Jersey - epidemiology</topic><topic>ORIGINAL PAPER</topic><topic>Philadelphia - epidemiology</topic><topic>Sampling methods</topic><topic>Studies</topic><topic>United States</topic><topic>Urban areas</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Patterson, Freda</creatorcontrib><creatorcontrib>Zhang, Guo</creatorcontrib><creatorcontrib>Davey, Adam</creatorcontrib><creatorcontrib>Tan, Yin</creatorcontrib><creatorcontrib>Ma, Grace X.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Education Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Education Collection</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Education Database</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Social Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Environmental Science Database</collection><collection>ProQuest One Education</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>Environmental Science Collection</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Safety Science and Risk</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of community health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Patterson, Freda</au><au>Zhang, Guo</au><au>Davey, Adam</au><au>Tan, Yin</au><au>Ma, Grace X.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>American Heart Association’s Ideal Cardiovascular Health Metrics in Under-Represented Asian Americans</atitle><jtitle>Journal of community health</jtitle><stitle>J Community Health</stitle><addtitle>J Community Health</addtitle><date>2016-12-01</date><risdate>2016</risdate><volume>41</volume><issue>6</issue><spage>1282</spage><epage>1289</epage><pages>1282-1289</pages><issn>0094-5145</issn><eissn>1573-3610</eissn><coden>JCMHBR</coden><abstract>The American Heart Association’s ideal cardiovascular health score is based on 7 cardiovascular health metrics to measure progress toward their Impact Goal of reducing cardiovascular disease by 20 % before 2020. This study applied this construct to assess cardiovascular health in a sample of Asian Americans. Convenience sampling methods were used to enroll self-identified Asian American’s over the age of 18 years who were attending community health fairs across the greater Philadelphia and urban areas of New Jersey. The heart health metrics of tobacco use, body mass index, physical activity, diet, blood pressure, and glucose were measured. In the greater sample (N = 541), 82 % were female, the mean age was 65.1 (SD = 15.5) years, 45 % were Vietnamese, 38 % were Chinese and 17 % were Korean. Prevalence of ideal heart health for the metrics of tobacco use (95 %) was high. Only 19.4 % achieved ideal levels of physical activity, 35.1 % for BMI, 28.9 % for glucose and 66 % for blood pressure. Dietary intake was ideal for 20.7 % of the sample. More years since migration and Korean race trended toward having a higher prevalence of poor health in some metrics. Most Asian Americans are not achieving ideal cardiovascular health for several of the metrics evaluated, with those residing in the United States for more than 13 years and Korean Americans being higherrisk groups. Targeted community based intervention approaches to improving and monitoring heart health in Asian American, and Asian American subgroups, are needed.</abstract><cop>New York</cop><pub>Springer Science + Business Media</pub><pmid>27363824</pmid><doi>10.1007/s10900-016-0217-3</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0094-5145 |
ispartof | Journal of community health, 2016-12, Vol.41 (6), p.1282-1289 |
issn | 0094-5145 1573-3610 |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5083159 |
source | MEDLINE; SpringerNature Journals; JSTOR Archive Collection A-Z Listing; EBSCOhost Education Source |
subjects | Aged American Heart Association Asian Americans Blood pressure Body Composition Cardiovascular disease Cardiovascular diseases Cardiovascular Diseases - epidemiology Cardiovascular Diseases - ethnology Community and Environmental Psychology Diet Ethics Female Health Promotion and Disease Prevention Health Status Heart Disorders Humans Male Medicine Medicine & Public Health Middle Aged Migration New Jersey - epidemiology ORIGINAL PAPER Philadelphia - epidemiology Sampling methods Studies United States Urban areas |
title | American Heart Association’s Ideal Cardiovascular Health Metrics in Under-Represented Asian Americans |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-29T08%3A26%3A34IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-jstor_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=American%20Heart%20Association%E2%80%99s%20Ideal%20Cardiovascular%20Health%20Metrics%20in%20Under-Represented%20Asian%20Americans&rft.jtitle=Journal%20of%20community%20health&rft.au=Patterson,%20Freda&rft.date=2016-12-01&rft.volume=41&rft.issue=6&rft.spage=1282&rft.epage=1289&rft.pages=1282-1289&rft.issn=0094-5145&rft.eissn=1573-3610&rft.coden=JCMHBR&rft_id=info:doi/10.1007/s10900-016-0217-3&rft_dat=%3Cjstor_pubme%3E48716484%3C/jstor_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1833024669&rft_id=info:pmid/27363824&rft_jstor_id=48716484&rfr_iscdi=true |