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Gender and Race Disparities in Cardiovascular Disease Risk Factors among New York City Adults: New York City Health and Nutrition Examination Survey (NYC HANES) 2013–2014

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Abstract

While gender and racial/ethnic disparities in cardiovascular disease (CVD) risk factors have each been well characterized, few studies have comprehensively examined how patterns of major CVD risk factors vary and intersect across gender and major racial/ethnic groups, considered together. Using data from New York City Health and Nutrition Examination Survey 2013–2014—a population-based, cross-sectional survey of NYC residents ages 20 years and older—we measured prevalence of obesity, hypertension, hypercholesterolemia, smoking, and diabetes across gender and race/ethnicity groups for 1527 individuals. We used logistic regression with predicted marginal to estimate age-adjusted prevalence ratio by gender and race/ethnicity groups and assess for potential additive and multiplicative interaction. Overall, women had lower prevalence of CVD risk factors than men, with less hypertension (p = 0.040), lower triglycerides (p < 0.001), higher HDL (p < 0.001), and a greater likelihood of a heart healthy lifestyle, more likely not to smoke and to follow a healthy diet (p < 0.05). When further stratified by race/ethnicity, however, the female advantage was largely restricted to non-Latino white women. Non-Latino black women had significantly higher risk of being overweight or obese, having hypertension, and having diabetes than non-Latino white men or women, or than non-Latino black men (p < 0.05). Non-Latino black women also had higher total cholesterol compared to non-Latino black men (184.4 vs 170.5 mg/dL, p = 0.010). Despite efforts to improve cardiovascular health and narrow disparities, non-Latino black women continue to have a higher burden of CVD risk factors than other gender and racial/ethnic groups. This study highlights the importance of assessing for intersectionality between gender and race/ethnicity groups when examining CVD risk factors.

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Acknowledgments

Role of Funding Source: Support for NYCHANES 2013–2014 was provided by the de Beaumont Foundation with additional support from the Robert Wood Johnson Foundation, Robin Hood, the NYS Health Foundation, Quest Diagnostics, and the Doris Duke Charitable Foundation, NYC Health Department, Hunter College Office of the Provost, CUNY Vice Chancellors Office of Research, and CUNY School of Public Health Dean’s Office. The effort of NI, CTS, and LT was supported in part by grants U58DP005621 and U48DP005008 (Centers for Disease Control and Prevention), grant U54MD000538-15 (NIH National Institute on Minority Health and Health Disparities). NI and CTS were also partially supported through grant 1R01DK110048-01A1 (NIH National Institute of Diabetes and Digestive and Kidney Diseases), and grant UL1 TR001445 (National Center for Advancing Translational Sciences). The contents of this paper are solely the responsibility of the authors and do not represent the official views of the funders

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Authors and Affiliations

  1. Department of Population Health, NYU School of Medicine, New York, NY, 10016, USA

    Rania Kanchi, Chau Trinh-Shevrin, Nadia Islam, Azizi Seixas & Lorna E. Thorpe

  2. NYC Department of Health and Mental Hygiene, Long Island City, NY, USA

    Sharon E. Perlman, Claudia Chernov, Winfred Wu & Bahman P. Tabaei

  3. Universidad De La Salle, Bogota, Colombia

    Jesica Rodriguez-Lopez

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  1. Rania Kanchi
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  2. Sharon E. Perlman
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All authors have equally contributed to the development of this manuscript by taking part in constructing the conception, analysis/interpretation, or writing of the manuscript. They also all reviewed and commented on the manuscript. The authors have full access to the data and are responsible for the integrity of the data and the analysis.

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Correspondence to Rania Kanchi.

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Kanchi, R., Perlman, S.E., Chernov, C. et al. Gender and Race Disparities in Cardiovascular Disease Risk Factors among New York City Adults: New York City Health and Nutrition Examination Survey (NYC HANES) 2013–2014. J Urban Health 95, 801–812 (2018). https://doi.org/10.1007/s11524-018-0287-x

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