Neighborhood socioeconomic and racial disparities in angiography and coronary revascularization: the ARIC surveillance study.

TitleNeighborhood socioeconomic and racial disparities in angiography and coronary revascularization: the ARIC surveillance study.
Publication TypeJournal Article
Year of Publication2012
AuthorsRose KM, Foraker RE, Heiss G, Rosamond WD, Suchindran CM, Whitsel EA
JournalAnn Epidemiol
Volume22
Issue9
Pagination623-9
Date Published2012 Sep
ISSN1873-2585
KeywordsAdult, African Continental Ancestry Group, Aged, Comorbidity, Confidence Intervals, Coronary Angiography, European Continental Ancestry Group, Healthcare Disparities, Humans, Medicaid, Middle Aged, Myocardial Infarction, Myocardial Revascularization, Prevalence, Smoking, Socioeconomic Factors, United States
Abstract

PURPOSE: Disparities in the receipt of angiography and subsequent coronary revascularization have not been well-studied.

METHODS: We estimated prevalence ratios and 95% confidence intervals (PR, 95% CIs) for the association between neighborhood-level income (nINC) and receipt of angiography; and among those undergoing angiography, receipt of revascularization procedures, among 9941 hospitalized myocardial infarction patients under epidemiologic surveillance by the Atherosclerosis Risk in Communities Study (1993-2002).

RESULTS: In analyses by tertile of nINC controlling for age, study community, gender, and year, compared with white patients from high nINC areas, black patients from low nINC (0.60, 0.54-0.66) and medium nINC (0.70, 0.60-0.78) areas, as well as white patients from low nINC areas (0.83, 0.75-0.91) were less likely to receive angiography, whereas black patients from high nINC and white patients from medium nINC areas were not. Associations were attenuated, but persisted, after we controlled for event severity, medical history, receipt of Medicaid, and hospital type. Compared with high nINC white patients, black patients were less likely, and white patients were as likely, to undergo cardiac revascularization, given receipt of an angiogram.

CONCLUSIONS: Black and lower nINC patients were less likely to undergo angiography than were white patients and those from higher nINC areas. Among those receiving angiography, race, but not nINC, gradients persisted.

DOI10.1016/j.annepidem.2012.06.100
Alternate JournalAnn Epidemiol
PubMed ID22809799
PubMed Central IDPMC3418426
Grant ListN01-HC-55022 / HC / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
1R01HL080287 / HL / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
R01 HL080287 / HL / NHLBI NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
N01-HC-55015 / HC / NHLBI NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
R24 HD050924 / HD / NICHD NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
5-T32-HL007055-30 / HL / NHLBI NIH HHS / United States