TY - JOUR
T1 - Social determinants of emergency department visits among persons diagnosed with coronary heart disease and stroke
AU - Baptiste, Diana Lyn
AU - Turkson-Ocran, Ruth Alma
AU - Han, Hae Ra
AU - Himmelfarb, Cheryl Dennison
AU - Commodore-Mensah, Yvonne
N1 - Funding Information:
Dr. Turkson-Ocran is supported by the Strategically Focused Research Network Award from the American Heart Association: 17SFRN33590069. Dr. Himmelfarb is supported by the National Institutes for Health/ National Institute for Nursing Research, P30NR018093, Hopkins Center to Promote resilience in persons and families living with multiple chronic conditions Dr. Commodore-Mensah is supported by the Johns Hopkins Institute of Clinical and Translational Research through a grant from the National Center for Advancing Translational Sciences of the National Institutes of Health under award number: 5KL2TR001077-05.
Publisher Copyright:
© 2021 Ethnicity and Disease, Inc.. All rights reserved.
PY - 2021/12
Y1 - 2021/12
N2 - Background: Social determinants of health (SDOH) are associated with a variety of health outcomes, yet their relation to emergency department (ED) visits among individuals with coronary heart disease (CHD) or stroke is unclear. Objective: We examined whether SDOH were associated with ≥1 ED visit among persons diagnosed with CHD or stroke. Methods: We performed a cross-sectional analysis of the 2010-2018 National Health Interview Survey, examining ED visits among individuals who self-reported CHD or stroke diagnosis. The outcome was defined as reporting ≥1 ED visit in the previous 12 months vs none. The SDOH examined were race, employment status, poverty, insurance status, marital status, and educational status. Results: We included N=14,925 participants with a diagnosis of CHD or stroke. The mean (±SD) age was 68 (±.14) years. After adjusting for age and sex, non-Hispanic Blacks were more likely (adjusted odds ratio [AOR]: 1.29; 95%CI: 1.15-1.44) to report having ≥1 ED visits than Whites. Compared with Whites, Asians had lower odds of having ≥1 ED visit in the previous 12 months (AOR: .63, 95%CI: .49-.82). Those who were unmarried (AOR: 1.21, 95%CI: 1.12 – 1.31), unemployed (AOR: 1.53, 95%CI: 1.36-1.72) and had a poverty income ratio of <1 (AOR: 1.47, 95%CI: 1.31-1.67) had higher odds of having ≥1 ED visits. Conclusion: Being Black, unmarried, unemployed, and having lower income levels were associated with a higher likelihood of having ≥1 ED visits in the prior 12 months among individuals with a CHD or stroke diagnosis. SDOH should be considered when developing systematic interventions to prevent costly ED visits.
AB - Background: Social determinants of health (SDOH) are associated with a variety of health outcomes, yet their relation to emergency department (ED) visits among individuals with coronary heart disease (CHD) or stroke is unclear. Objective: We examined whether SDOH were associated with ≥1 ED visit among persons diagnosed with CHD or stroke. Methods: We performed a cross-sectional analysis of the 2010-2018 National Health Interview Survey, examining ED visits among individuals who self-reported CHD or stroke diagnosis. The outcome was defined as reporting ≥1 ED visit in the previous 12 months vs none. The SDOH examined were race, employment status, poverty, insurance status, marital status, and educational status. Results: We included N=14,925 participants with a diagnosis of CHD or stroke. The mean (±SD) age was 68 (±.14) years. After adjusting for age and sex, non-Hispanic Blacks were more likely (adjusted odds ratio [AOR]: 1.29; 95%CI: 1.15-1.44) to report having ≥1 ED visits than Whites. Compared with Whites, Asians had lower odds of having ≥1 ED visit in the previous 12 months (AOR: .63, 95%CI: .49-.82). Those who were unmarried (AOR: 1.21, 95%CI: 1.12 – 1.31), unemployed (AOR: 1.53, 95%CI: 1.36-1.72) and had a poverty income ratio of <1 (AOR: 1.47, 95%CI: 1.31-1.67) had higher odds of having ≥1 ED visits. Conclusion: Being Black, unmarried, unemployed, and having lower income levels were associated with a higher likelihood of having ≥1 ED visits in the prior 12 months among individuals with a CHD or stroke diagnosis. SDOH should be considered when developing systematic interventions to prevent costly ED visits.
KW - Coronary Heart Disease
KW - Emergency Department
KW - Social Determinants of Health
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=85100660826&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85100660826&partnerID=8YFLogxK
U2 - 10.18865/ED.31.1.41
DO - 10.18865/ED.31.1.41
M3 - Article
C2 - 33519154
AN - SCOPUS:85100660826
SN - 1049-510X
VL - 31
SP - 41
EP - 46
JO - Ethnicity and Disease
JF - Ethnicity and Disease
IS - 1
ER -