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Life's Simple 7 in Two U.S. Populations Facing Cardiovascular Disease- and Cancer- Related Health Disparities

Weier, Rory Cusack
http://orcid.org/0000-0003-4746-9132
http://rave.ohiolink.edu/etdc/view?acc_num=osu1439330788

Abstract Details

2015, Doctor of Philosophy, Ohio State University, Public Health.
Cardiovascular disease (CVD) and cancer, leading causes of morbidity and mortality in the U.S., share modifiable sources of risk. Health disparities, which are differences in the incidence, prevalence, mortality and burden of disease that should not exist, are influenced by wide-ranging social determinants of health. This research sought to address the need for improved understanding of the status and social determinants of mutual sources of CVD and cancer risk among two U.S. populations facing health disparities, Puerto Ricans living in the contiguous U.S. and residents of Appalachia, using The American Heart Association’s Life’s Simple 7 of Cardiovascular Health (LS7) metric and data from the Boston Puerto Rican Health Study (BPRHS) and Appalachian Community Cancer Network (ACCN). LS7 includes well-defined poor, intermediate and ideal levels of smoking, body mass index (BMI), physical activity, diet, blood pressure, total cholesterol and plasma glucose, modifiable behaviors and factors associated with CVD and cancer. The goals of this research were to: (1) quantify and compare LS7 across BPRHS and ACCN study participants and a nationally representative sample of civilian, non-institutionalized non-Hispanic whites from the National Health and Nutrition Examination Survey (NHANES), and (2) independently assess the relationship between geographic food access and LS7 healthy diet score among BPRHS and ACCN study participants. There were significant differences in the distribution of several LS7 components and overall LS7 score between BPRHS and ACCN study participants, BPRHS and NHANES participants, and ACCN study and NHANES participants. Results suggest smoking, BMI, and plasma glucose warrant further investigation among BPRHS participants and BMI and blood pressure warrant further investigation among ACCN study participants. Diet was also identified as a risk behavior for prioritization among BPRHS and ACCN study participants since <=1% of each research sample met four or more of the five dietary recommendations comprising the LS7 healthy diet score. Consequently, this study also examined the relationship between geographic food access, distance-based barriers and facilitators to food purchasing and consumption, and LS7 healthy diet score. Although suggested as a potentially influential social determinant, geographic food access was not found to be associated with a significant change in the odds of a poor LS7 healthy diet score among either BPRHS or ACCN study participants. The findings of this study can be used by researchers, public health officials and policy makers to prioritize modifiable sources of CVD and cancer risk, for which BPRHS and ACCN study participants had unfavorable distributions, for future research and intervention to ultimately reduce health disparities among these research populations. However, more representative data are needed to make generalizations to all mainland Puerto Ricans and residents of Appalachia. Geographic food access is an expanding area of research in the context of diet, despite the null results of this study and others. Consequently, research reflecting the complexity of the way in which diet, the county’s leading modifiable chronic disease risk factor, is influenced by geographic food access and other social determinants of health is necessary to inform policy and research efforts seeking to address CVD and cancer health disparities.
Electra Paskett (Committee Chair)
Randi Foraker (Committee Member)
Michelle Kaiser (Committee Member)
Abigail Shoben (Committee Member)
238 p.
Epidemiology; Public Health
Cardiovascular disease; cancer; modifiable chronic disease risk factors; Lifes Simple 7; social determinants of health; health disparities; Puerto Rican; Appalachian; geographic food access

Recommended Citations

Citations

  • Weier, R. C. (2015). Life's Simple 7 in Two U.S. Populations Facing Cardiovascular Disease- and Cancer- Related Health Disparities [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1439330788

    APA Style (7th edition)

  • Weier, Rory. Life's Simple 7 in Two U.S. Populations Facing Cardiovascular Disease- and Cancer- Related Health Disparities. 2015. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1439330788.

    MLA Style (8th edition)

  • Weier, Rory. "Life's Simple 7 in Two U.S. Populations Facing Cardiovascular Disease- and Cancer- Related Health Disparities." Doctoral dissertation, Ohio State University, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=osu1439330788

    Chicago Manual of Style (17th edition)

osu1439330788
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© 2015, all rights reserved.
This open access ETD is published by The Ohio State University and OhioLINK.