Abstract 17213: Myocardial Infarction and Stroke Awareness Among US and Foreign-Born Adults in the 2014 and 2017 National Health Interview Survey

Abstract

Background: Atherosclerotic cardiovascular disease, defined as nonfatal myocardial infarction (MI), coronary heart disease death, or fatal or nonfatal stroke, is the leading cause of death in the United States (US). MI and stroke symptom awareness reduces delays in hospitalization and mortality. We hypothesized that foreign-born persons will have lower stroke and MI symptom awareness than US-born persons. Methods: We analyzed cross-sectional data from the 2014 and 2017 National Health Interview Surveys (NHIS) on US-born and foreign-born adults from 9 regions of birth (Europe, South America, Mexico/Central America/Caribbean, Russia, Africa, Middle East, Indian subcontinent, Asia, and Southeast Asia). Our outcomes were stroke and MI symptom awareness, and the best action to take during a stroke or MI event. Awareness was defined as knowing all 5 symptoms of MI or stroke respectively, and choosing “call 911” as the best action to take in the event of an MI or stroke. Generalized linear models with Poisson distribution and a logarithmic link was used to assess disparities in awareness between foreign-born and US-born persons. We compared responses from 2014 and 2017 to assess improvement in awareness. Results: We included 63,439 participants, with mean age 38.2 years; 51% were female and 50% had less than high school education. After adjusting for age, sex, and education, we observed significant variation in MI and stroke symptom awareness and best action to take by region of birth [Table]. In comparison to US-born, foreign-born persons were less aware of MI and stroke symptoms and the best action to take. Improvement in awareness was not significant in all groups between 2014 and 2017. Conclusion: These findings suggest a disparity in MI and stroke symptom awareness among immigrants in the US. Culturally tailored public health education and health literacy initiatives are needed to help reduce these disparities in awareness.