Evidence map›Paper›PMID 33661959›Full record

ArticlePloS one2021

Cuba's cardiovascular risk factors: International comparison of levels and education gradients.

Maria Dieci, Juan J Llibre-Rodriguez, Daisy Acosta, William H Dow

Abstract readComparative Study
In one paragraph

Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Maria DieciBerkeley School of Public Health, University of California, Berkeley, CA, United States of America.ORCID 0000-0002-5364-8789
Juan J Llibre-RodriguezFacultad de Medicina Finlay-Albarran, Medical University of Havana, Havana, Cuba.
Daisy AcostaUniversidad Nacional Pedro Henriquez Ureña, Santo Domingo, Dominican Republic.
William H DowBerkeley School of Public Health, University of California, Berkeley, CA, United States of America.

Funding

Program Development (Pilot)P30AG012839 · NIA · UNIVERSITY OF CALIFORNIA BERKELEY · PI William H Dow · 1999 to 2026
$18.6M
INTERDISCIPLINARY TRAINING IN DEMOGRAPHYT32HD007275 · NICHD · UNIVERSITY OF CALIFORNIA BERKELEY · PI FEEHAN, DENNIS MICHAEL · 1985 to 2025
$5.3M
Dementia Determinants in Caribbean and U.S. HispanicsR01AG064778 · NIA · UNIVERSITY OF CALIFORNIA BERKELEY · PI DOW, WILLIAM H. · 2019 to 2023
$3.6M
NIA NIH HHS P30 AG012839NIA NIH HHS R01 AG064778NICHD NIH HHS T32 HD007275
6 · The paper itself

Abstract

backgroundCuba's life expectancy at 79 is third highest in Latin America. Many attribute this to social investments in health and education, but comparative research is sparse, thus we compare Cuba with neighboring Dominican Republic, Costa Rica due to its strong social protections, and the U.S. Given high cardiovascular mortality, we focus on cardiovascular risk factor levels. To assess the role of health care, we distinguish medically amenable biomarkers from behavioral risk factors. To assess the role of Cuba's focus on equity, we compare education gradients in risk factors.

methodsWe analyze Cuban data from the 10/66 Dementia Research Group baseline survey of urban adults ages 65 plus. Comparison samples are drawn from the Dominican Republic 10/66 survey, the Costa Rican CRELES, and U.S. NHANES. We analyze cross-country levels and education gradients of medically amenable (hypertension, diabetes, hypercholesterolemia, access to health care) and behavioral (smoking, obesity) risk factors,-using sex-stratified weighted means comparisons and age-adjusted logistic regression.

resultsNeither medically amenable nor behavioral risk factors are uniformly better in Cuba than comparison countries. Obesity is lower in Cuba, but male smoking is higher. Hypertension, diabetes, and hypercholesterolemia levels are high in all countries, though Cuba's are lower than Costa Rica. Hypertension awareness in Cuba is similar to Costa Rica. Cuba has a higher proportion of hypertensives on treatment than Costa Rica, though lower than the U.S. Comparative gradients by education are similarly mixed. For behavioral factors, Cuba shows the strongest gradients (primarily for men) among the countries compared: smoking improves, but obesity worsens with education. Hypertension awareness also improves with education in Cuba, but Cuba shows no significant differences by education in hypertension treatment.

conclusionSmoking is comparatively high in Cuba, but obesity is low, and the resulting biomarkers show comparatively mixed patterns. Cuba's social protections have not eliminated strong educational gradients in behavioral risk factors, but the healthcare system appears to have eliminated disparities such as in hypertension treatment.

Indexed as

AgedCardiovascular DiseasesCosta RicaCubaDatabases, FactualDominican RepublicEducational StatusFemaleHealth FacilitiesHumansHypercholesterolemiaHypertensionLife ExpectancyMaleObesityPublic Policy

Identifiers

PMID33661959
PMCPMC7932107

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.