ETHNIC AND SOCIOECONOMIC DIFFERENCES IN CARDIOVASCULAR-DISEASE RISK-FACTORS - FINDINGS FOR WOMEN FROM THE THIRD NATIONAL-HEALTH AND NUTRITION EXAMINATION SURVEY, 1988-1994

Context.-Cardiovascular disease (CVD) risk factors are higher among et hnic minority women than among white women in the United States. Howev er, because ethnic minority women are disproportionately poor, socioec onomic status (SES) may substantially explain these risk factor differ ences. Objective.-To determine whether differences in CVD risk factors by ethnicity could be attributed to differences in SES. Design.-Third National Health and Nutrition Examination Survey conducted between 19 88 and 1994. Setting.-Eighty-nine mobile examination centers. Particip ants.-A total of 1762 black, 1481 Mexican American, and 2023 white wom en, aged 25 to 64 years, who completed both the home questionnaire and medical examination. Main Outcome Measures.-Ethnicity and years of ed ucation (SES) in relation to systolic blood pressure, cigarette smokin g, body mass index (BMI, a measure of weight in kilograms divided by t he square of height in meters), physical inactivity, non-high-density lipoprotein cholesterol (non-HDL-C [the difference between total chole sterol and HDL-C]), and non-insulin-dependent diabetes mellitus. Resul ts.-As expected, most CVD risk factors were higher among ethnic minori ty women than among white women. After adjusting for years of educatio n, highly significant differences in blood pressure, BMI, physical ina ctivity, and diabetes remained for both black and Mexican American wom en compared with white women (P<.001). In addition, women of lower SES from each of the 3 ethnic groups had significantly higher prevalences of smoking and physical inactivity and higher levels of BMI and non-H DL-C than women of higher SES (P<.001). Conclusions.-These findings pr ovide the greatest evidence to date of higher CVD risk factors among b lack and Mexican American women than among white women of comparable S ES. The striking differences by both ethnicity and SES underscore the critical need to improve screening, early detection, and treatment of CVD-related conditions for black and Mexican American women, as well a s for women of lower SES in all ethnic groups.