Ideal Cardiovascular Health in Urban Jamaica: Prevalence Estimates and Relationship to Community Property Value, Household Assets and Educational Attainment

Abstract

BACKGROUND: Ideal cardiovascular health (ICH) is associated with greater longevity and reduced morbidity, but no research on ICH has been conducted in Jamaica. We estimated the prevalence of ICH in urban Jamaica and evaluated associations between ICH and community, household and individual socioeconomic status (SES). METHODS: Cross-sectional study using data from 360 men and 665 women, age ≥20 years in urban Jamaica. ICH was defined as having seven characteristics: current non-smoking, healthy diet, moderate physical activity, and normal body mass index, blood pressure, glucose, and cholesterol. Logistic regression, weighted for survey design, quantified association between the outcome (≥5 ICH characteristics [ICH-5]), and exposure variables (tertiles of community median land value [MLV], tertiles of household assets and educational attainment). RESULTS: Prevalence of ICH (7 characteristics) was 0.51%, while prevalence of ICH-5 was 22.9% (male 24.5%, female 21.5%, p=0.447). In sex-specific multivariable models adjusted for age, education, and household assets, men in the lower tertiles of community MLV had lower odds of ICH-5 compared to men in the upper tertile (lowest tertile: OR 0.33, 95%CI 0.12-0.91, p=0.032; middle tertile: OR 0.46 (0.20-1.04) p=0.062). Women from communities in the lower and middle tertiles of MLV also had lower odds of ICH-5, but association was not statistically significant. Educational attainment was inversely associated with ICH-5 among men and positively associated among women. No significant association was seen for household assets. CONCLUSION: Prevalence of ICH is low in urban Jamaica. Living in poorer communities was associated with lower odds of ICH-5 among men. Higher education was associated with higher odds of ICH-5 among women but lowers odds among men.

Ideal Cardiovascular Health in a Nationally Representative Population-Based Sample of Adults in Malawi

“…A recent NCD model of care review in sub-Saharan Africa also revealed that leveraging existing human resources, decentralization of NCD care to primary health facilities, task redistribution including to lay health cadres, designing patient-centered quality of care, and continued training and mentorship are key to successes of NCD treatment and control [ 24 ]. Although community screening and sensitization on the need for NCD care is critical, strategies are needed to ensure better linkage and retention into care [ 17 ].…”

“…Sociodemographic factors associated with ICH may include female sex [63 high income countries-HIC and 28 low- and middle-income countries-LMIC, 10 , Brazil, 14 , Nepal, 15 ], younger age [63 HIC and 28 LMIC, 10 , Uganda, 12 , Brazil, 14 , Nepal, 15 , China, 16 ], ethnicity [Brazil, 14 ], higher education [Uganda, 12 , Brazil, 14 ], higher income [Jamaica, 17 , China, 18 ], lower income [Uganda, 12 ], rural residence [Ghana, 13 , Peru, 19 ], and geographic region [Brazil, 20 ]. This study aimed to determine the prevalence, distribution, and correlates of ideal ICH among adults in Malawi in 2017.…”