NEWS

Study of Southern rural women shows race is not cardiovascular risk factor

CHAPEL HILL -- Race is not a risk factor for cardiovascular disease among Southern rural women, according to a study by researchers at the University of North Carolina at Chapel Hill.

Studying 1,110 white and black women in three rural North Carolina counties, Drs. Susan Appel and Joanne Harrell, both of the School of Nursing, and doctoral candidate Shibing Deng of the School of Public Health’s department of biostatistics found that education level and body mass index, or body weight adjusted for height, were greater indicators of risk for cardiovascular disease than race.

The results appeared in the recent issue of Nursing Research dedicated to health disparities.

"Our study tells us that race should be viewed as a risk marker, or a variable that may be associated with a higher prevalence of a disease, rather than a risk factor, a variable that is directly related to morbidity and mortality," said Appel. "Previous research directly connecting race with increased risk of cardiovascular disease usually has not taken into account the socioeconomic status of the participants."

Study participants responded to questions about their race, education, family income, personal health history, personal health behaviors, height and weight.

The results showed that the black women had significantly lower education and income levels, higher body mass index (BMI), and a greater prevalence of hypertension, angina and diabetes than their white counterparts.

In analysis examining race, income and education, the researchers found that education and race were significant predictors of cardiovascular risk. When the study was adjusted for body mass index, however, race was no longer a significant factor.

"While it’s true that a higher number of African-American women suffer from cardiovascular disease than white women, it is their generally lower education level and higher BMI that puts them at greater risk, not their race," said Appel.

The researchers said their study results suggest that further research should focus on risk reduction interventions for all Southern rural women with limited education, not just black women.

"We knew that low socioeconomic status rural African-American women were at high risk for heart disease, but this study indicates that low socioeconomic status rural white women are also at high risk," said Appel. "Management of weight is an important factor for researchers and practitioners to focus their interventions on in order to reduce cardiovascular risk among rural Southern women with low education levels."

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Contact note: Appel may be reached at Appel@email.unc.edu

School of Nursing contact: Sunny Smith Nelson, (919) 966-1412