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The Geographic Distribution of Cardiovascular Health in SPHERE

Roth, Caryn
http://rave.ohiolink.edu/etdc/view?acc_num=osu1397559331

Abstract Details

2014, Master of Public Health, Ohio State University, Public Health.
Introduction: Coronary heart disease and stroke are leading causes of morbidity and mortality in the United States (US) and cost the healthcare system an estimated $315.4 billion annually. Area-level factors which impact health may affect the distribution of cardiovascular disease (CVD), given its multifactorial and chronic nature. Objective: We sought to characterize the geographic distribution of cardiovascular health (CVH) among women over 65 years of age involved in the ongoing Stroke Prevention in Healthcare Delivery EnviRonmEnts (SPHERE) Study. Methods: Data derived from electronic health records (EHRs) were collected from all women over 65 years of age in two Midwest primary care clinics. We characterized CVH according to the American Heart Association’s Life’s Simple 7 campaign, which scores modifiable risk factors for CVH and attributes a higher score to better health. We characterized these factors using the collected patient data, and geocoded patient addresses to the level of the US census tract. We integrated census tract population characteristics into the analysis to determine if they were associated with CVH. We conducted sensitivity analyses for missing data on the overall CVH score, as well as for some of the individual components of the score. We calculated the mean fractional score, the actual CVH score divided by the maximum possible. The association between US census tract characteristics and CVH was measured using univariate linear regression. Results: The mean fractional score was .63 across both clinics. Few patients were in ideal CVH, and the distribution of overall CVH and individual factors differed geographically. Only weekly per capita expenditure on fruits and vegetables was associated with CVH score at the 0.05 significance level. Imputing missing values had little effect on overall patient CVH classification. Discussion: Our patient population has significant room for improvement in modifiable behaviors and factors that contribute to CVH. By empowering patients to understand their health with their primary care physicians, we can encourage behavior changes and shift the population distribution of CVH. In order to do this most effectively, we must deploy interventions that are relevant and actionable for diverse patient and provider populations, which can vary within one medical center. Augmenting EHR-based data with available census tract-level data provides additional opportunities to understand our patient population and consider the lifestyle and socioeconomic factors that impact their health.
Philip Payne, PhD (Committee Chair)
Foraker Randi, PhD (Advisor)
Lai Albert, PhD (Committee Member)
53 p.
Health; Health Care; Public Health
Electronic Health Records; Cardiovascular Health; Primary Care; Prevention; Geographic Information System; Learning Healthcare System

Recommended Citations

Citations

  • Roth, C. (2014). The Geographic Distribution of Cardiovascular Health in SPHERE [Master's thesis, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1397559331

    APA Style (7th edition)

  • Roth, Caryn. The Geographic Distribution of Cardiovascular Health in SPHERE. 2014. Ohio State University, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1397559331.

    MLA Style (8th edition)

  • Roth, Caryn. "The Geographic Distribution of Cardiovascular Health in SPHERE." Master's thesis, Ohio State University, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=osu1397559331

    Chicago Manual of Style (17th edition)

osu1397559331
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© 2014, all rights reserved.
This open access ETD is published by The Ohio State University and OhioLINK.