News Release

New UCSF Report Profiles Statewide And Regional Heart Disease Risk Factors

Peer-Reviewed Publication

University of California - San Francisco

In a survey of 36,004 California residents, researchers at the University of California San Francisco and the California Department of Health Services found that significant variations in cardiovascular risk factors exist between different ethnic/racial groups and regions in California.

"The results reveal where the state stands in dealing with the major contributors of the leading cause of death in California -- heart disease," said Jeannie Gazzaniga, PhD, epidemiologist, Institute for Health and Aging, UCSF School of Nursing, and lead author of the study.

The new report profiles statewide and regional rates for five cardiovascular disease risk factors during the thirteen-year period between 1984 and 1996 including high blood pressure, diabetes, weight, physical activity and smoking. Researchers identified health conditions and behaviors based on 36,004 California adult residents -- responses to survey questions on a variety of health behaviors.

"We identified high risk groups statewide and within each of the ten regions of the state. The report tells us where to direct our prevention efforts," added Gazzaniga.

"We know that the same risk factors operate among all race and ethnic groups. The variation of risk factor prevention between groups and regions may be explained in part by differences in access to health care and inadequate resources and delivery of prevention programs targeting high risk groups," she said.

Mark Alexander, PhD, assistant director of the UCSF Medical Effectiveness Research Center, who conducts research regarding health disparity among various racial and ethnic groups, said that the study highlights the persistent inequities in health outcomes for African Americans and Latinos in California. "These inequities can only be corrected if those who are capable of providing solutions first develop a mechanism to accept group responsibility and a common set of goals," Alexander said. "This study further documents that the current strategy of segmented health care delivery is failing most of California's diverse populations."

Researchers reported that rates of high blood pressure hovered at about 20 percent for the study period of 1984 to 1996. Forty-one and a half percent of African American men surveyed in the study had almost twice the rate of high blood pressure compared to 22.8 percent of white and 22.1 percent of Hispanic men surveyed. Thirty-five percent of African American women surveyed had a blood pressure rate approximately 50 percent higher than 23.7 percent of white and 25 percent of Hispanic women surveyed. Almost half of Californians over age 65 in the study had high blood pressure while only 15 percent of those 44 years or younger surveyed had high blood pressure.

Statewide the proportion of adults in the study with diabetes fluctuated between 3.5 percent and 5.5 percent during the thirteen-year period of the study. Fourteen and a half percent of African Americans and 12.9 percent of Hispanics in the study had the highest rates of diabetes. Among Californians of all ethnicities in the study, 13.8 percent of those over the age of 65 and those with a high school education or less had a 40 percent greater chance of having diabetes compared to adults with a college degree.

People defined as having diabetes or high blood pressure are those who said they had been told by their doctor that they suffered from one of these conditions. In 1984, researchers found that 19 percent of men and 16.7 percent of women in California who were surveyed were overweight as defined as those with a body mass index equal to or greater than 27.8 for men and 27.3 for women. Twelve years later, the percentages had increased dramatically. In 1996, 27 percent of men and 26.8 percent of women in the study were overweight. Hispanic women in the study were most likely to be overweight (42.7 percent), followed by African American women (40.2 percent), and African American men (37 percent). Fewer than 17 percent of 18-24 year olds in the study were overweight compared to nearly 33 percent of people aged 45 to 54. California residents who were surveyed with a high school diploma or less were 1.6 times more likely to be overweight compared to those people in the study who graduated from college.

In addition, according to the study, statewide rates of physical inactivity have remained high. About half of African American and white men and women in the study were sedentary in 1996, as defined as having not participated in any physical activity including running, golfing, gardening and walking, for the past month.

The prevalence of inactivity among men increased significantly, from 45 percent in 1984, to 54.3 percent in 1996; and approximately 55 percent of women led inactive lives in 1996. Hispanic men (70.4 percent) and women (66.2 percent) in the study were most likely to be sedentary. Researchers identified no significant differences in activity across age groups in the study, but found that 62.9 percent of those with a high school diploma or less had higher rates of inactivity compared to 44.2 percent of Californians with a college education. In other findings from the study, smoking declined 34 percent for men and 40.5 percent for women from 1984 to 1996. Among women, African Americans surveyed reported the highest rates of smoking (26.8 percent), followed by whites (19.2 percent), and Hispanics (11.1 percent). Among men, whites reported the highest smoking rates (22 percent), followed by Hispanics (19.2 percent), and African Americans (13.6 percent). Californians aged 18-24 reported the highest rates of smoking of any group (23.8 percent). Residents with a high school diploma or less who were surveyed had twice the rate of smoking compared to college graduates (23.5 percent versus 11.7 percent). Researchers defined smokers as those who had smoked more than 100 cigarettes ever and who currently smoke.

The study was conducted by the Cardiovascular Disease Outreach, Resources and Epidemiology (CORE) Program. The CORE Program was created to heighten awareness of cardiovascular disease -- including heart disease and stroke -- among Californians and to gather resources to combat the disease. For a copy of the report, Cardiovascular Disease Risk Factors Among California Adults, 1984-1996, call 916-324-1329 or email cdunn@dhs.ca.gov.

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