Health Insurance Status as a Barrier to Ideal Cardiovascular Health for US Adults: Data from the National Health and Nutrition Examination Survey (NHANES)

作者：McClurkin Michael A; Yingling Leah Rae; Ayers Colby; Cooper McCann Rebecca; Suresh Visakha; Nothwehr Ann; Barrington Debbie S; Powell Wiley Tiffany M^*

来源：PLos One, 2015, 10(11): e0141534.

DOI：10.1371/journal.pone.0141534

Background
Little is known about the association between cardiovascular (CV) health and health insurance status. We hypothesized that U.S. adults without health insurance coverage would have a lower likelihood of ideal cardiovascular health.
Methods and Results
Using National Health and Nutrition Examination Survey (NHANES) data from 2007-2010, we examined the relationship between health insurance status and ideal CV health in U.S. adults aged >= 19 years and <65 (N = 3304). Ideal CV health was defined by the American Heart Association (AHA) as the absence of clinically manifested CV disease and the simultaneous presence of 6-7 "ideal" CV health factors and behaviors. Logistic regression modeling was used to determine the relationship between health insurance status and the odds of ideal CV health. Of the U.S. adult population, 5.4% attained ideal CV health, and 23.5% were without health insurance coverage. Those without health insurance coverage were more likely to be young (p<0.0001), male (p<0.0001), non-white (p<0.0001), with less than a high school degree (p<0.0001), have a poverty-to-income ratio less than 1 (p<0.0001) and unemployed (p<0.0001) compared to those with coverage. Lack of health insurance coverage was associated with a lower likelihood of ideal CV health; however, this relationship was attenuated by socioeconomic status.
Conclusions
U.S. adults without health insurance coverage are less likely to have ideal CV health. Population-based strategies and interventions directed at the community-level may be one way to improve overall CV health and reach this at-risk group.

• 出版日期2015-11-4
• 单位NIH