Article ; Online: Trends in Poor Health Indicators Among Black and Hispanic Middle-aged and Older Adults in the United States, 1999-2018.
JAMA network open
2020 Volume 3, Issue 11, Page(s) e2025134
Abstract: ... indicators have improved or become worse among Black and Hispanic middle-aged and older adults ... from the Behavioral Risk Factor Surveillance System from January 1999 through December 2018 of persons who self-identified as Black (non-Hispanic ... Hispanic (non-White), or White and who were 45 years or older.: Exposure: The 1999 legislation to reduce ...
| Abstract | Importance: Adults who belong to racial/ethnic minority groups are more likely than White adults to receive a diagnosis of chronic disease in the United States. Objective: To evaluate which health indicators have improved or become worse among Black and Hispanic middle-aged and older adults since the Minority Health and Health Disparities Research and Education Act of 2000. Design, setting, and participants: In this repeated cross-sectional study, a total of 4 856 326 records were extracted from the Behavioral Risk Factor Surveillance System from January 1999 through December 2018 of persons who self-identified as Black (non-Hispanic), Hispanic (non-White), or White and who were 45 years or older. Exposure: The 1999 legislation to reduce racial/ethnic health disparities. Main outcomes and measures: Poor health indicators and disparities including major chronic diseases, physical inactivity, uninsured status, and overall poor health. Results: Among the 4 856 326 participants (2 958 041 [60.9%] women; mean [SD] age, 60.4 [11.8] years), Black adults showed an overall decrease indicating improvement in uninsured status (β = -0.40%; P < .001) and physical inactivity (β = -0.29%; P < .001), while they showed an overall increase indicating deterioration in hypertension (β = 0.88%; P < .001), diabetes (β = 0.52%; P < .001), asthma (β = 0.25%; P < .001), and stroke (β = 0.15%; P < .001) during the last 20 years. The Black-White gap (ie, the change in β between groups) showed improvement (2 trend lines converging) in uninsured status (-0.20%; P < .001) and physical inactivity (-0.29%; P < .001), while the Black-White gap worsened (2 trend lines diverging) in diabetes (0.14%; P < .001), hypertension (0.15%; P < .001), coronary heart disease (0.07%; P < .001), stroke (0.07%; P < .001), and asthma (0.11%; P < .001). Hispanic adults showed improvement in physical inactivity (β = -0.28%; P = .02) and perceived poor health (β = -0.22%; P = .001), while they showed overall deterioration in hypertension (β = 0.79%; P < .001) and diabetes (β = 0.50%; P < .001). The Hispanic-White gap showed improvement in coronary heart disease (-0.15%; P < .001), stroke (-0.04%; P < .001), kidney disease (-0.06%; P < .001), asthma (-0.06%; P = .02), arthritis (-0.26%; P < .001), depression (-0.23%; P < .001), and physical inactivity (-0.10%; P = .001), while the Hispanic-White gap worsened in diabetes (0.15%; P < .001), hypertension (0.05%; P = .03), and uninsured status (0.09%; P < .001). Conclusions and relevance: This study suggests that Black-White disparities increased in diabetes, hypertension, and asthma, while Hispanic-White disparities remained in diabetes, hypertension, and uninsured status. |
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| MeSH term(s) | Black or African American/statistics & numerical data ; Aged ; Arthritis/ethnology ; Asthma/ethnology ; Coronary Disease/ethnology ; Cross-Sectional Studies ; Depression/ethnology ; Diabetes Mellitus/ethnology ; Female ; Health Status Disparities ; Health Status Indicators ; Hispanic or Latino/statistics & numerical data ; Humans ; Hypertension/ethnology ; Insurance, Health/trends ; Kidney Diseases/ethnology ; Male ; Medically Uninsured/ethnology ; Middle Aged ; Minority Health/trends ; Sedentary Behavior/ethnology ; Stroke/ethnology ; United States/epidemiology ; White People/statistics & numerical data |
| Keywords | covid19 |
| Language | English |
| Publishing date | 2020-11-02 |
| Publishing country | United States |
| Document type | Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S. |
| ISSN | 2574-3805 |
| ISSN (online) | 2574-3805 |
| DOI | 10.1001/jamanetworkopen.2020.25134 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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