Increasing Disparity in Knowledge of Cardiovascular Disease Risk Factors and Risk-Reduction Strategies by Socioeconomic Status: Implications for Policymakers

Abstract

During the 1980s extensive local and national cardiovascular health promotion campaigns were implemented to improve knowledge of risk reduction. This study analyzed changes from 1980 to 1990 in knowledge of acquired cardiovascular risk factors (i.e., actual, objective knowledge of adverse lifestyle factors affecting cardiovascular health); perceived knowledge of risk-reduction strategies (i.e., subjective knowledge about how to reduce the likelihood of cardiovascular disease); and interest in risk modification (i.e., interest in changing risk-factor habits) by socioeconomic status using level of education. The study population included 2,455 women and men 25-74 years of age from three population-based cross-sectional surveys in two northern California cities. We found significant differentials in baseline knowledge that widened over the 10-year study period, resulting in larger disparities across educational groups at the final survey in 1990 (P < .05). From 1980 to 1990, individuals with < 12 years of education experienced only slight improvement in their knowledge of cardiovascular risk factors (mean summary score of 4.4 increasing to 5.5, based on a 17-item questionnaire of risk factors); those with > or = 16 years of education experienced twice as much improvement (mean of 8.4 increasing to 11.1) (P < .05). There were similar time-effect disparities in knowledge of risk-reduction strategies (P < .05). In contrast, interest in risk modification was high for all educational groups and remained uniform across time. The continuing and widening disparity in knowledge between socioeconomic groups suggests the need for policymakers to reform existing cardiovascular risk-reduction education campaigns.