TY - JOUR
T1 - Association of participation in Cardiac Rehabilitation with Social Vulnerability Index
T2 - The behavioral risk factor surveillance system
AU - Kianoush, Sina
AU - Al Rifai, Mahmoud
AU - Patel, Jaideep
AU - George, Jerin
AU - Gulati, Martha
AU - Taub, Pam
AU - Moran, Tyler
AU - Shapiro, Michael D.
AU - Agarwala, Anandita
AU - Ullah, Waqas
AU - Lavie, Carl J.
AU - Bittner, Vera
AU - Ballantyne, Christie Mitchell
AU - Virani, Salim S.
N1 - Publisher Copyright:
© 2022
PY - 2022/3/1
Y1 - 2022/3/1
N2 - Objectives: To identify whether social vulnerability is associated with low cardiac rehabilitations (CR) use, a Class I recommendation by current treatment guidelines following acute myocardial infarction (AMI). Methods: We performed this cross-sectional study using the 2017 Behavioral Risk Factor Surveillance System (BRFSS) survey. The Centers for Disease Control and Prevention Social Vulnerability Index (CDC SVI) was calculated using 15 social risk factors from 4 main themes including socioeconomic status, household composition and disability, minority status and language, and housing type and transportation. A higher SVI indicates higher social vulnerability. We used multivariable logistic regression models to evaluate the association of CR use with state-level SVI adjusted for demographic, behavioral, socioeconomic, and comorbidity variables. Results: A total 2093 participants with history of AMI were included. Out of total, 61.7% were older than 65 years, 42.5% female, 72.5% White, and 42.4% used CR. Participation in CR was lower among females (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.44–0.91), those without a primary care physician (OR, 0.45; 95% CI, 0.23–0.87), and higher with college degree education (OR, 1.95; 95% CI, 1.06–3.59). CR use decreased with increasing SVI tertiles (1st =61%, 2nd =52%, and 3rd =35%). Compared with those residing in states in the 1st tertile, CR use was lower in the 2nd (OR, 0.68; 95% CI, 0.47–0.98) and 3rd (OR, 0.33; 95% CI 0.23–0.48) SVI tertiles. Conclusion: CR use following AMI is low and is associated with social vulnerability. Identifying social risk factors may help improve access to care among vulnerable populations.
AB - Objectives: To identify whether social vulnerability is associated with low cardiac rehabilitations (CR) use, a Class I recommendation by current treatment guidelines following acute myocardial infarction (AMI). Methods: We performed this cross-sectional study using the 2017 Behavioral Risk Factor Surveillance System (BRFSS) survey. The Centers for Disease Control and Prevention Social Vulnerability Index (CDC SVI) was calculated using 15 social risk factors from 4 main themes including socioeconomic status, household composition and disability, minority status and language, and housing type and transportation. A higher SVI indicates higher social vulnerability. We used multivariable logistic regression models to evaluate the association of CR use with state-level SVI adjusted for demographic, behavioral, socioeconomic, and comorbidity variables. Results: A total 2093 participants with history of AMI were included. Out of total, 61.7% were older than 65 years, 42.5% female, 72.5% White, and 42.4% used CR. Participation in CR was lower among females (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.44–0.91), those without a primary care physician (OR, 0.45; 95% CI, 0.23–0.87), and higher with college degree education (OR, 1.95; 95% CI, 1.06–3.59). CR use decreased with increasing SVI tertiles (1st =61%, 2nd =52%, and 3rd =35%). Compared with those residing in states in the 1st tertile, CR use was lower in the 2nd (OR, 0.68; 95% CI, 0.47–0.98) and 3rd (OR, 0.33; 95% CI 0.23–0.48) SVI tertiles. Conclusion: CR use following AMI is low and is associated with social vulnerability. Identifying social risk factors may help improve access to care among vulnerable populations.
KW - Cardiac rehabilitation
KW - Myocardial infarction
KW - Preventive cardiology
KW - Socioeconomic factors
KW - Vulnerable populations
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U2 - 10.1016/j.pcad.2022.02.003
DO - 10.1016/j.pcad.2022.02.003
M3 - Article
C2 - 35182577
AN - SCOPUS:85125656557
SN - 0033-0620
VL - 71
SP - 86
EP - 91
JO - Progress in Cardiovascular Diseases
JF - Progress in Cardiovascular Diseases
ER -