ArticlePharmacoepidemiology and drug safety2013
Methods for estimation of disparities in medication use in an observational cohort study: results from the Multi-Ethnic Study of Atherosclerosis.
Article in Pharmacoepidemiology and drug safety, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 11 citations in OpenAlex.
- Structural and social determinants of health: The multi-ethnic study of atherosclerosis.PloS one · 2024Article
- Long-Term Exposures to Urban Noise and Blood Pressure Levels and Control Among Older Adults.Hypertension (Dallas, Tex. : 1979) · 2021Article
- Barriers in utilizing lipid-lowering agents in non-institutionalized population in the U.S.: Application of a theoretical framework.PloS one · 2021Article
- Longitudinal Analysis of Long-Term Air Pollution Levels and Blood Pressure: A Cautionary Tale from the Multi-Ethnic Study of Atherosclerosis.Environmental health perspectives · 2018Article
- Charting the Future for Ethnicity and Health Research: Clinical and Population Science Insights From the MESA.Global heart · 2016Article
- Article
- Periodic limb movements during sleep and prevalent hypertension in the multi-ethnic study of atherosclerosis.Hypertension (Dallas, Tex. : 1979) · 2015Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
purposeEvaluating disparities in health care is an important aspect of understanding differences in disease risk. The purpose of this study is to describe the methodology for estimating such disparities, with application to a large multi-ethnic cohort study.
methodsThe Multi-Ethnic Study of Atherosclerosis includes 6814 participants aged 45-84 years free of cardiovascular disease. Prevalence ratio (PR) regression was used to model baseline lipid lowering medication (LLM) or anti-hypertensive medication use at baseline as a function of gender, race, risk factors, and estimated pre-treatment biomarker values.
resultsHispanics and African Americans had lower prevalence of medication use than did non-Hispanic whites, even at the same risk factor profile. This became non-significant after adjusting for socioeconomic status. Although gender did not influence the prevalence of LLM use (PR = 1.09, 95%CI 0.95-1.25), there were differences in the association of diabetes and HDL with LLM use by gender. Men were significantly less likely to be on anti-hypertensive medications than women (PR = 0.86, 95%CI 0.80-0.92, p < 0.001), and this was not explained by risk factors or socioeconomic status. Lack of health insurance strongly influenced medication use, controlling for risk factors and other markers of socioeconomic status.
conclusionsDisparities exist in the treatment of cholesterol and hypertension. Hispanics and African Americans had less use of LLM; men had less use of anti-hypertensives. Risk factors have differential associations with medication use depending on gender. Methods described in this paper can provide improved disparity estimation in observational cohort studies.
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