|Institution:||University of Washington|
|Keywords:||Border; Cardiovascular disease; Hypertension; Mexico; Obesity; Smoking; Public health; Epidemiology; Global Health|
|Full text PDF:||http://hdl.handle.net/1773/40807|
Background: Cardiovascular disease is a major cause of morbidity and mortality in the United States (U.S.) and Mexico. We aimed to describe the sex-specific prevalence and time trends in five risk factors for cardiovascular disease (smoking, physical activity, obesity, diabetes mellitus and hypertension) by county or municipality that touches the U.S.-Mexico border. Then we aimed to describe the prevalence by socioeconomic status (SES). Methods: We calculated sex-specific estimates on the county-level for diabetes mellitus, hypertension, obesity, physical activity and tobacco use. Data was obtained from surveys; for the U.S., prevalence (95% uncertainty intervals) were calculated using the Center for Disease Controls annual Behavioral Risk Factor Surveillance System (BRFSS) and the National Health and Nutrition Examination Survey (NHANES), and for Mexico, prevalence (95% confidence intervals) were calculated from the Mexican Encuesta Nacional de Salud y Nutricin (ENSANUT) surveys in 2005-06 and in 2011-12. Results: Prevalence estimates were available for 26 counties in 4 U.S. states and 14 municipalities in 6 Mexican states. The risk factors with the highest prevalence in the U.S. were any physical activity (68.8%), obesity (38.1%) and hypertension (35.5%). The risk factor with the lowest prevalence was diabetes mellitus (17.5%). Whereas, in Mexico the risk factors with the highest average prevalence were any smoking (51.0%), hypertension (48.9%) and obesity (35.9%). The risk factor with the lowest prevalence was diabetes mellitus (7.1%). The prevalence of any physical activity was also alarmingly low at 8.9%. Smoking had a positive association with increasing SES for females but not for males in both countries. Physical activity had a positive association with increasing SES for both sexes. Obesity and diabetes mellitus had a negative association with increasing SES. Hypertension had a negative association with increasing SES but it was stronger for females than males. Conclusions: There is a high burden of cardiovascular risk factors along the U.S.-Mexico border region with a strong association between risk factors prevalence and a county or municipalitys human development index. Public health programs should investigate regional socioeconomic status when planning intervention programs as they may have adverse effects on cardiovascular disease risk factors.Advisors/Committee Members: Prado, Bernardo H (advisor).