DOI: 10.1161/str.55.suppl_1.wp97 ISSN: 0039-2499

Abstract WP97: Disparities in Health-Related Quality of Life Among Adults With Heart Disease, Stroke, and Both Conditions

Molly Jacobs, Elizabeth Evans, Charles Ellis
  • Advanced and Specialized Nursing
  • Cardiology and Cardiovascular Medicine
  • Neurology (clinical)

Background: Notable racial and ethnic disparities exist in cardiovascular disease (CVD) and stroke epidemiology; however, few studies have assessed the disparate quality of life (QOL) among individuals living with CVD, stroke, or both. This study evaluated the impact of these conditions on health related QOL (HRQOL) and quantified demographic disparities.

Methods: Using data from the 2021 National Health Interview Survey (NHIS), we calculated the Health and Activity Limitation Index (HALex)—a generic HRQOL measure comprising perceived health and activity limitations—for 29,482 adults. Stratified analysis and ordinary least-squares regressions were used to adjust for sex, age, income, education, urbanicity, marital status, household size, region of residence, and insurance status. Differences in HRQOL were estimated across racial and ethnic groups with and without CVD, stroke, or both conditions. To test the robustness of study findings, analyses were repeated using the EQ-5D.

Results: Adjusted HRQOL was lower for Blacks (-0.014, SE=0.004) and Hispanics (-0.012, SE=0.003) compared to Whites. Compared those with neither CVD nor stroke, individuals with CVD only (-0.21, SE=0.015), stroke only (-0.29, SE=0.028), and both conditions (-0.44, SE=0.040) had 20% to 44% lower HRQOL. Even after for age, income, education, and income, diagnosis with stroke only (-0.19, SE=0.081), CVD only (-0.12, SE=0.051), or both (-0.44, SE=0.040) lowered the HRQOL more for Blacks than Whites, while other racial/ethnic groups showed no statistically significant difference HRQOL. In general, geographic location, sex, and household composition had little impact on HRQOL, but higher age, lower educational attainment, and low/middle income was associated with significant reductions in HRQOL.

Conclusion: CVD and stroke were independently associated with significantly low HRQOL, their co-occurrence has a substantially negative impact on HRQOL for all individuals particularly Blacks who had the largest HRQOL impact in all three condition groups. Findings suggest that public health interventions should be aimed at improving HRQOL among individuals diagnosed with these conditions, especially the most vulnerable groups.

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