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Associations between social risk factors and the American Heart Association's life's simple 7 in US adults: NHANES 2015-2016

Herbert, Brandon (2019) Associations between social risk factors and the American Heart Association's life's simple 7 in US adults: NHANES 2015-2016. Master Essay, University of Pittsburgh.

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Background: Risk of cardiovascular disease (CVD) is attenuated by healthy lifestyle choices. Identifying patients at increased risk for developing CVD based on modifiable risk factors is crucial for reducing the burden of disease. The American Heart Association’s Life’s Simple 7 (LS7) is commonly used to assess modifiable cardiovascular risk factors in individuals and communities.
Hypothesis: Individuals with (a) limited English proficiency or (b) lower socioeconomic status (SES) will have lower rates of ideal cardiovascular health when compared to participants proficient in English or with higher SES.
Methods: Data on adults ages ≥25 years from the 2015-2016 National Health and Nutrition Examination Survey (NHANES) cycle were analyzed. The AHA’s LS7 was used to measure cardiovascular health. The LS7 score ranges from 0 to 14 points where 7 categories are assigned as either poor, intermediate, or ideal health status. SES was divided into three categories: low, middle, and high. Each category of SES was defined as a combination of poverty income ratio and education level. The LS7 score was analyzed as a continuous variable using regression analyses and each individual dichotomized LS7 component was examined by race, English proficiency, and SES categories.
Results: Among 5,053 participants, we observed significant differences in LS7 scores by race/ethnicity, SES and limited English proficiency. With multivariable adjusted linear regression, low and middle SES was associated with significantly lower average LS7 scores than those in the high SES category (β=-1.41 [p<0.001], β=-0.89 [p<0.001]). Limited English proficiency was not significantly related with the LS7 score. The LS7 components that differed between low and high SES participants were glycohemoglobin, smoking status, physical activity, and diet. Non-Hispanic blacks had lower rates of ideal cardiovascular health in 6 of the 7 components that comprise the LS7 score (p<0.01 for all 6 components).
Conclusions: This study provides insight into the relations between cardiovascular health, SES, limited English proficiency, and race/ethnicity. Large disparities in ideal cardiovascular health metrics across SES and racial/ethnic groups are significant to the field of public health. Population-level interventions need to be refined in order to address these disparities. The contribution of limited English proficiency to CVD risk requires further study.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Herbert, BrandonBMH81@pitt.edubmh81
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairBrooks, MariaMBROOKS@pitt.edumbrooksUNSPECIFIED
Committee MemberMagnani, Jaredmagnanij@pitt.edumagnanijUNSPECIFIED
Committee MemberMair, Christinacmair@pitt.educmairUNSPECIFIED
Date: 19 December 2019
Date Type: Submission
Number of Pages: 62
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Uncontrolled Keywords: Cardiovascular disease; American Heart Association’s Life’s Simple 7; limited English proficiency; socioeconomic status.
Date Deposited: 20 Aug 2020 17:32
Last Modified: 01 Jan 2022 06:15


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