Examining The Relationship Between Stroke Risk Factor Profiles, Stress (Allostatic Load) And Stroke Among African American Women By Place Of Birth
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Type of WorkText
DepartmentPublic Health and Policy
ProgramDoctor of Public Health
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Cerebrovascular accident (CVA) also known as stroke, is a serious health condition that has high mortality and disability impact. African American women have high incidence, mortality and disability from stroke compared to other major races in the US and this is in spite of several prevention interventions that have been implemented. This poses a reason for concern and mean that a different approach to stroke research and stroke prevention strategies for African American women is necessary. One important approach in research is to study the African American population by place of birth. Many epidemiological reports do not make distinctions within the Black race in the United States by place of birth or by place of origin though the African American population comprise of Blacks born in the United States and immigrant Blacks from Africa, the Caribbean and other countries. Culture and family practices have been documented in past researches to have different effects on behaviors that may predispose heterogeneous groups within races to diseases like stroke. Making this distinction within the Black race by place of birth may unveil unique differences in health risk and the lessons learned can be used to inform targeted interventions and relevant health policies. Another concern related to stroke risk among African American women is that stress has been documented as a risk factor for stroke but limited research has been done to determine how stress is related to stroke for African American women by place of birth. The purpose of this study is to examine the relationship between Stroke Risk Factor Profile (SRFP), stress (allostatic load) and stroke among African American women by place of birth. This is a cross-sectional study. From NHANES IV survey population, a sample of 2,525 African American women aged 20 – 80 years were used to conduct the analyses. There were 227 (8.9%) in the foreign-born comparison group and the rest 2,298 (91.1%) were US-born. Stroke Risk Factor Profile scores (SRFP scores) were statistically generated based on the number of stroke risk factor variable each study participant exhibited out of a total of 12 used in the study. A SRFP score of 0 -3 was considered low SRFP (N=1,546), while a score of 4-12 was considered high SRFP (N=979). A similar process was used to determine the allostatic load score resulting in 1,491 in the low allostatic load category and 1,034 in the high allostatic load category. The findings from this research are as follows; • US-born African American women have higher SRFP compared to foreign-born AA women (41.0% vs 38.3%) • Adjusted logistic regression showed that US-born women with High SRFP had 2.74 higher odds of stroke (OR = 2.74, 95% CI = 1.87, 4.01, p = <0.001 • There was no significant difference in allostatic load between US-born African American women and foreign-born African American women • Adjusted logistic regression showed that US-born with high allostatic load had 1.69 higher odds of stroke (OR = 1.69, 95% CI = 1.09, 2.59, p = 0.019). • There was an increase in stroke risk by age and a decrease in stroke risk by education. Based on the results from this research, high SRFP and high allostatic load are associated with higher risk for stroke for US-born African American women.