Racial and Ethnic Disparities in Perceived Health Status Among Patients With Cardiovascular Disease

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There were 241,228 observations in MEPS during 2014–2021 (weighted frequency = 323,795,124); 59,549 participants aged less than 18 years were excluded; 181,679 adults aged 18 years or older were assessed for CVD diagnosis (weighted frequency = 250,459,053); 162,160 Participants without a CVD diagnosis were excluded; 19,519 adults with 1 or more CVD diagnoses were assessed for race and ethnicity (weighted frequency = 25,775,758); 897 participants who self-identified as not being non-Hispanic Black, Hispanic, or non-Hispanic White were excluded; 18,622 non-Hispanic Black, non-Hispanic White, or Hispanic individuals (weighted frequency = 24,259,222) remained; 6,907 participants were excluded for following reasons: data for age at the first CVD diagnosis were not available (n = 3,950); data for age were not available (n = 247); data for physical and cognitive limitations were not available (n = 474); data on perceived health status were not available (n = 1,807); and other covariates had negative weight (n = 429). The final analytic sample consisted of 11,715 non-Hispanic Black, non-Hispanic White, or Hispanic adults with CVD (weighted frequency = 15,431,283).

Figure 1.
Flowchart showing the process of determining the number of adults included in a study on racial and ethnic differences in perceived health status among adults with CVD. Data are from MEPS, 2014–2021. Abbreviations: CVD, cardiovascular disease; MEPS, Medical Expenditure Panel Survey.

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This figure consists of a series of text boxes. The first box is labeled “Patient factors” and is in a row by itself; it reads “Racial and ethnic disparity.” Below this are 3 boxes: predisposing factors, enabling factors, and need factors. Predisposing factors are age, sex, and education. Enabling factors are physical limitation, cognitive limitation, income level, and health insurance type. Need factors are age at first CVD diagnosis, CVD severity, and Elixhauser Comorbidity Index. Underneath the large text box on patient factors is a text box that notes 2 external factors: region and data collection year. The text boxes for patient factors and external factors have arrows that lead to another text box: Health behaviors, which lists 2 behaviors: one or more CVD-related outpatient visit and total health care expenditures. The text boxes for patient factors and external factors also have arrows that lead to a final text box: Health outcome. The single health outcome is perceived health status.

Figure 2.
Proposed conceptual model based on Andersen’s Behavioral Model of Health Services Use (14). Abbreviation: CVD, cardiovascular disease.

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