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Impact of economic recession on cardiovascular health across 30 major American cities
Thesis

Impact of economic recession on cardiovascular health across 30 major American cities

Abinaya Arulselvan
Master of Public Health (M.P.H.), Drexel University
Jun 2014
DOI:
https://doi.org/10.17918/etd-6108
pdf
Arulselvan_Abinaya_20141.60 MB
PDF Access upon request, Email title, URL, or DOI to archives@drexel.edu

Abstract

Recessions--Economic aspects Cardiovascular System Public Health
Background: The economic recession from 2007 to 2009 created great fiscal challenges for American cities that have made them slow to recover. Economic instability causes increased unemployment rates forcing many to opt for compromised unhealthy lifestyles and increased mental stress. Therefore, the impact of economic recession on population's health has become a major concern. Objective: To study the impact of economic recession on cardiovascular disease (CVD) among urban population aged 18 years and older in 30 major cities in United States. Methods: The study with an ecological design was conducted using data from 2006-2012 Behavioral Risk Factor Surveillance System (BRFSS). Thirty largest cities by population were included in the analysis. Participants' health conditions including prevalence of CVD were defined on the basis of self-reported physician-diagnosis of disease. Differences in CVD prevalence across the 30 cities and associations of CVD with socioeconomic and behavior risk factors were examined using univariate and multivariate analysis approaches. All analysis was conducted using SAS 9.3 software. Results: Among 997161 participants of the total study sample, the prevalence of coronary heart disease (CHD) and stroke was 8.6% and 4.2%. Increasing age was a significant predictor for both the cardiovascular disease. Males had increased odds of developing CVD than females. Native Americans/Alaskan Indians followed by Blacks and had greater odds for CVD. Detroit, St. Louis and San Antonio had highest prevalence of CVD, while San Francisco, Seattle and Minneapolis had the lowest. Age adjusted results showed increased prevalence during economic recession period in all cities. Per capita real GDP, cigarette smoking, diabetes, depression, obesity, education, employment and income were significantly associated with CVD. Conclusion: The study confirms that in addition to the study of well-established CVD risk factors, such as smoking and obesity, economic recession has a significant impact on cardiovascular health among urban population. Further studies are needed to test the potential mechanisms by which economic recession causes the risk of CVD.

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