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  • 1
    Online Resource
    Online Resource
    Abstract 15625: Social Determinants of Health and Non-cigarette Tobacco Products:results From the 2014-2017 National Health Interview Survey
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Circulation Vol. 142, No. Suppl_3 ( 2020-11-17)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 142, No. Suppl_3 ( 2020-11-17)
    Abstract: Introduction: The recent decline in use of cigarette products has been offset by an increase in non-cigarette tobacco products (NCP) among young individuals. In this study, we assess the prevalence and association of NCP use across the range of social determinants of health (SDOH) among a nationally representative population of young U.S. adults. Hypothesis: Lower SDOH is associated with higher likelihood of NCP use. Methods: We utilized cross-sectional data from the 2014-2017 National Health Interview Survey (NHIS). Current use of e-cigarettes, smokeless tobacco, and other NCP was self-reported. Relevant SDOH features were identified based on published literature and included 39 key items from 6 major domains. Each of these items was scored 1 if unfavorable and 0 if favorable and summed to derive a total SDOH risk score. Weighted multivariable logistic regression was used to assess the association between computed SDOH risk quartiles and NCP use. Results: The study population consisted of 53,023 participants (mean age 30 [SD 7] years, 50% men, 58% white), which translates to 113M US adults. Of them, 4.2%, 3.0% and 6.1% reported current use of e-cigarettes, smokeless tobacco and other NCP products, respectively with overall (any) NCP use at 11.6%. The respective prevalence in non-cigarette users was 2.3%, 2.4% and 4.4%. A graded increase in age-adjusted prevalence of specific and overall NCP was noted across increasing SDOH risk score quartiles ( Figure). Accounting for demographics and comorbidities, those in the highest SDOH risk score quartile vs lowest had 1.86-fold higher odds of use of e-cigarettes (1.49-2.34), smokeless tobacco (1.33 [1.05-1.68]) and overall NCP (1.44 [1.26-1.65] ). Conclusions: In a nationally representative sample, 1 in 14 young adults with the most unfavorable SDOH profile reported NCP use. Evaluation of SDOH may provide opportunities for targeted public health approaches to prevent NCP use and its ensuing complications.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.142.suppl_3.15625
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1466401-X
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  • 2
    Online Resource
    Online Resource
    Determinants of Influenza Vaccine Uptake in Patients With Cardiovascular Disease and Strategies for Improvement
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Journal of the American Heart Association Vol. 10, No. 15 ( 2021-08-03)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 10, No. 15 ( 2021-08-03)
    Abstract: Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. Influenza infection is associated with an increased risk of cardiovascular events (myocardial infarction, stroke, and heart failure exacerbation) and mortality, and all‐cause mortality in patients with CVD. Infection with influenza leads to a systemic inflammatory and thrombogenic response in the host body, which further causes destabilization of atherosclerotic plaques. Influenza vaccination has been shown to be protective against cardiovascular and cerebrovascular events in several observational and prospective studies of at‐risk populations. Hence, many international guidelines recommend influenza vaccination for adults of all ages, especially for individuals with high‐risk conditions such as CVD. Despite these long‐standing recommendations, influenza vaccine uptake among US adults with CVD remains suboptimal. Specifically, vaccination uptake is strikingly low among patients aged 〈 65 years, non‐Hispanic Black individuals, those without health insurance, and those with diminished access to healthcare services. Behavioral factors such as perceived vaccine efficacy, vaccine safety, and attitudes towards vaccination play an important role in vaccine acceptance at the individual and community levels. With the ongoing COVID‐19 pandemic, there is a potential threat of a concurrent epidemic with influenza. This would be devastating for vulnerable populations such as adults with CVD, further stressing the need for ensuring adequate influenza vaccination coverage. In this review, we describe a variety of strategies to improve the uptake of influenza vaccination in patients with CVD through improved understanding of key sociodemographic determinants and behaviors that are associated with vaccination, or the lack thereof. We further discuss the potential use of relevant strategies for COVID‐19 vaccine uptake among those with CVD.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.120.019671
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2653953-6
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  • 3
    Online Resource
    Online Resource
    Abstract 15274: Social Determinants of Suboptimal Cardiovascular Health Among Pregnant Women in United States
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Circulation Vol. 142, No. Suppl_3 ( 2020-11-17)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 142, No. Suppl_3 ( 2020-11-17)
    Abstract: Introduction: Cardiovascular health (CVH) and social determinants of health (SDOH) have a significant impact on maternal morbidity and mortality. We assessed the association and cumulative effects of SDOH on CVH among a nationally representative sample of pregnant women in the United States. Methods: We included cross-sectional data of pregnant women aged 18 to 49 years from the National Health Interview Survey (2013-2017). We ascertained CVH based on the following CV risk factors: hypertension, diabetes mellitus, dyslipidemia, smoking, obesity, and physical activity; classifying participants into optimal (0-1) and suboptimal (≥2) CVH. For each individual, SDOH risk score was calculated that represents the cumulative number of distinct variables (present vs absent) identified on 39 sub-components for 6 domains (economic stability, neighborhood and physical environment, community and social context, food, education, and healthcare system access). SDOH risk score was aggregated and divided into 4 quartiles. Results: Among 1,433 (3.3%, representing 2.2 million) pregnant women in US, one third (33%) of pregnant women (mean age: 33 years, 13% non-Hispanic black) had suboptimal CVH. The prevalence of hypertension, smoking, obesity and physical inactivity across the increasing SDOH quartiles were noted. Overall, 52% pregnant women with unfavorable (4 th quartile) vs 27% with favorable (1 st quartile) SDOH had suboptimal CVH. In multivariable analyses, accounting for demographics and co-morbid conditions, pregnant women with unfavorable SDOH in 4 th quartile had nearly 3-fold higher odds of suboptimal CVH. (Figure). Conclusions: Aggregate SDOH risk score provides significant discrimination of CVH in pregnant women. In pregnant women, suboptimal CVH is common and more than 1 in 2 women with highest risk of SDOH inequities have suboptimal CVH, highlighting the public health urgency for intervention in young high risk women.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.142.suppl_3.15274
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
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    Online Resource
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