Exposure to structural racism-related state laws is associated with worse cardiovascular health among US adults, BRFSS 2011 and 2013.

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of epidemiology Pub Date : 2025-01-08 DOI:10.1093/aje/kwae176

Belinda L Needham, Darya Dokshina, Talha Ali, Kristi L Allgood, Megan Douglas, Akilah Dulin, Nancy L Fleischer, Amber E Johnson, Annie Ro, Madina Agénor

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引用次数: 0

Abstract

The objective of this study was to determine whether exposure to structural racism-related state laws is associated with cardiovascular health among a racially and ethnically diverse sample of US adults. Data were from the Database of Structural Racism-Related State Laws and the Behavioral Risk Factor Surveillance System (BRFSS). The sample included 958 019 BRFSS 2011 and 2013 respondents aged 18 years or older from all 50 US states. The exposure was a summary index of 22 state laws related to the criminal legal system, economics and labor, education, health care, housing, immigration, and political participation. The outcome was the American Heart Association's Life's Simple 7 (LS7), a summary index of 7 cardiovascular health indicators. Linear regression models included fixed effects for year and state to control for time trends and unmeasured, time-invariant, state-level contextual factors. In the full sample, a 1 SD increase in the structural racism state legal index was associated with a 0.06-unit decrease in the LS7 (b = -0.06; 95% CI, -0.09 to 0.02; P = .001), controlling for individual- and state-level covariates. Contrary to expectations, stratified models revealed no statistically significant differences by race and ethnicity in the association between the structural racism state legal index and the LS7.

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在美国成年人中，接触与结构性种族主义相关的州法律与心血管健康状况恶化有关，BRFSS，2011 年和 2013 年。

本研究的目的是确定在美国不同种族和民族的成年人样本中，接触与结构性种族主义相关的州法律是否与心血管健康有关。数据来自结构性种族主义相关州法律数据库和行为风险因素监测系统（BRFSS）。样本包括来自美国 50 个州的 958 019 名 18 岁以上的 BRFSS 2011 和 2013 年受访者。调查对象是与刑事法律制度、经济和劳动、教育、医疗保健、住房、移民和政治参与有关的 22 项州法律的汇总指数。结果是美国心脏协会的 "生命简单 7"（LS7），这是一项包含七项心血管健康指标的综合指数。线性回归模型包括年份和州的固定效应，以控制时间趋势和未测量的时变州级背景因素。在全样本中，结构性种族主义州法律指数每增加一个标准差，LS7 指数就会下降 0.06 个单位（b=-0.06；95% CI：-0.09，0.02；p=0.001），同时控制了个人和州层面的协变量。与预期相反，分层模型显示，在结构性种族主义州法律指数与 LS7 之间的关系上，不同种族和族裔之间没有显著的统计学差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.40

自引率

4.00%

发文量

221

审稿时长

3-6 weeks

期刊介绍： The American Journal of Epidemiology is the oldest and one of the premier epidemiologic journals devoted to the publication of empirical research findings, opinion pieces, and methodological developments in the field of epidemiologic research. It is a peer-reviewed journal aimed at both fellow epidemiologists and those who use epidemiologic data, including public health workers and clinicians.