The influence of socioeconomic factors on cardiovascular disease risk factors in the context of economic development in the Samoan archipelago

Ezeamama, Amara E.; Viali, Satupaitea; Tuitele, John; McGarvey, Stephen T.

doi:10.1016/j.socscimed.2006.06.023

Cited by 70 publications

(69 citation statements)

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“…The increased risk of chronic disease is amplified by an apparent genetic predisposition to obesity, diabetes, heart disease and hypertension (4,5) . The present paper considers key dietary characteristics of a population who identify with Samoan ancestry and reside in Logan, which is part of the Greater Brisbane region of South East Queensland.…”

Section: Migrant Health Pacific Islandersmentioning

confidence: 99%

Dietary habits of Samoan adults in an urban Australian setting: a cross-sectional study

Perkins

Ware

Tautalasoo³

et al. 2015

Public Health Nutr.

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Objective: To describe key characteristics of the dietary habits of Samoans residing in Logan, Queensland and to compare these characteristics with comparable populations. Design: Dietary intake was measured using a self-administered structured questionnaire between December 2012 and March 2013. Demographic characteristics included age and sex. Questionnaire results were compared with data from samples of Brisbane residents of similar social and economic characteristics and Pacific Islanders in New Zealand. The association between demographic characteristics and diet was investigated. Setting: Logan, Queensland, Australia. Subjects: Samoans aged 16 years and older. Results: A total of 207 Samoans participated, ninety-six (46 %) of whom were male. Of the participants, seventy-nine (38 %) were aged 16-29 years, sixty-three (30 %) were aged 30-49 years and sixty-five (31 %) were aged ≥50 years. Younger adults were significantly more likely to eat hamburgers, pizza, cakes, savoury pastries, potato crisps, sweets and soft drinks (all variables P < 0·001). Among Samoans, 44·7 % consumed two or more pieces of fruit daily, compared with 43·8 % of comparable Brisbane residents (relative risk = 1·0; 95 % CI 0·8, 1·2). Three or more servings of vegetables each day were consumed by 9·2 % of Samoans compared with 36·6 % of comparable Brisbane residents (relative risk = 3·8; 95 % CI 2·5, 6·0). Conclusions: Samoans are consuming significantly fewer vegetables and more discretionary foods than other populations. Socio-economic factors, length of stay in Australia and cultural practices may impact upon Samoans' diets. Further comprehensive studies on Samoans' dietary habits in Australia are recommended. Keywords Migrant health Pacific IslandersDietary intake Acculturation Nutritional inequalitiesPartially as a consequence of the adoption of Westernstyle diets (1)(2)(3) , rates of chronic disease, particularly obesity and type 2 diabetes mellitus, have increased dramatically in recent years among migrant Polynesian communities. The increased risk of chronic disease is amplified by an apparent genetic predisposition to obesity, diabetes, heart disease and hypertension (4,5) . The present paper considers key dietary characteristics of a population who identify with Samoan ancestry and reside in Logan, which is part of the Greater Brisbane region of South East Queensland. Henceforth, this population will be referred to as Samoans. Samoans are more susceptible to poor levels of population health as a result of various determinants underpinning their attitudes, access and knowledge of health care, such as socio-cultural issues, low socio-economic status and low health literacy (6,7) . Consequently, Samoans suffer disproportionate rates of non-communicable diseases and avoidable hospital admissions (7)(8)(9) . Queensland has a large Polynesian population of approximately 40 000, 38 % of whom identify with Samoan ancestry (10,11) . Little has been done to address the poor state of health of Samoan people in Australia.Diet qualit...

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Section: Migrant Health Pacific Islandersmentioning

confidence: 99%

Dietary habits of Samoan adults in an urban Australian setting: a cross-sectional study

Perkins

Ware

Tautalasoo³

et al. 2015

Public Health Nutr.

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“…The SES score assigned to each patient was the sum of education, annual household income, occupation, and medical reimbursement scores, as previously described (24)(25)(26). For ease of presentation and interpretation, we analyzed the study sample after stratifying by approximate tertiles of the score distribution ( Figure E1 in the online supplement): less than or equal to 5 (n ¼ 73), 6 to 7 (n ¼ 90), and greater than or equal to 8 (n ¼ 99).…”

Section: Socioeconomic Measuresmentioning

confidence: 99%

Lower Socioeconomic Status Is Associated with Worse Outcomes in Pulmonary Arterial Hypertension

Yang²,

Peng³

et al. 2013

Am J Respir Crit Care Med

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Rationale: Lower socioeconomic status (SES) confers a heightened risk of common cardiovascular and pulmonary diseases and increased mortality. The association of SES with outcomes in patients with pulmonary arterial hypertension (PAH) is less clear. Objectives: To determine the association between SES and outcomes in patients with PAH. Methods: We performed a prospective cohort study at a national referral center for patients with PAH in China. Two hundred sixty-two consecutive incident patients aged 18 to 65 years with a diagnosis of idiopathic PAH were recruited between January 2007 and June 2011 and followed up until November 2011. The primary endpoint was all-cause mortality. An SES score for each patient was derived from their educational level, annual household income, occupation, and medical reimbursement rate. Measurements and Main Results: Patients with a lower SES had higher unadjusted mortality rates, with 3-year survival estimates of 50.1, 70.8, and 86.0% in increasing tertiles of SES (P for trend , 0.001). After adjustment for clinical features, hemodynamics, and type of PAH treatment, the hazard ratios for death were 2.98 (95% confidence interval, 1.51-5.89) in the lowest tertile of SES and 1.80 (95% confidence interval, 0.89-3.63) in the middle tertile of SES compared with the upper tertile (P for trend ¼ 0.006).Conclusions: A lower SES is strongly associated with a higher risk of death in idiopathic PAH. This association was independent of clinical characteristics, hemodynamics, and treatment. Addressing the health disparities associated with a lower SES may improve the outcomes of patients with PAH.Keywords: pulmonary arterial hypertension; socioeconomic status; survival Pulmonary arterial hypertension (PAH) is a disease of the small muscular pulmonary arteries characterized by a progressive rise in pulmonary artery pressure and pulmonary vascular resistance (PVR), ultimately resulting in right heart failure and death (1-3). Treatment for PAH includes anticoagulants, diuretics, prostanoids, phosphodiesterase 5 inhibitors, and endothelin receptor antagonists (ERAs) (3-5). Although survival may have improved, patients with PAH still have a greatly increased risk of death, even with approved treatments. Socioeconomic status (SES) is defined by education, income, occupation, and social status and refers to an individual's social standing relative to other members of a society (6). A low SES is associated with increased risks of cardiovascular and pulmonary disease and mortality (7-11). However, the association of SES with outcomes in PAH has not been well studied.Socioeconomic-related inequalities in health and healthcare have increased over recent decades in . Approximately 75 to 80% of individuals with low annual household incomes do not carry medical insurance (15), potentially greatly increasing the economic burden of PAH on patients. Wilkens and colleagues reported that each patient with PAH in Germany spends €47,400 per year on average, primarily due to drug costs (16,17). In the United States...

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“…Numerous Pacific studies suggest that increasing rates of chronic diseases are associated with migration to urban areas (Joseph et al, 1983;Ostbye et al, 1989;Pawson and Janes, 1982;Prior et al, 1974;Salmond et al, 1985), urbanization (Baker et al, 1986;Benjamin, 2006;Coyne et al, 1984;DiBello et al, 2009;Ezeamama et al, 2006;Friedlaender, 1987;Harvey and Heywood, 1983;Hodge et al, 1995;Kende, 2001;King et al, 1994;Lindeberg et al, 1999;McGarvey et al, 1989;McGarvey, 1991;Norgan, 1995;Russell-Jones et al, 1990;Saweri, 2001;Taylor et al, 1991Taylor et al, , 1992Ulijaszek, 2003;Zimmet et al, 1978), and having relatives in urban areas, who send remittances and influence attitudes about cultural change (Ulijaszek, 2005). However, identifying specific behavioral changes associated with modernization is difficult.…”

mentioning

confidence: 99%

Behavioral changes associated with economic development in the South Pacific: Health transition in Vanuatu

Dancause

DeHuff

Soloway

et al. 2011

American J Hum Biol

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The influence of socioeconomic factors on cardiovascular disease risk factors in the context of economic development in the Samoan archipelago

Cited by 70 publications

References 58 publications

Dietary habits of Samoan adults in an urban Australian setting: a cross-sectional study

Dietary habits of Samoan adults in an urban Australian setting: a cross-sectional study

Lower Socioeconomic Status Is Associated with Worse Outcomes in Pulmonary Arterial Hypertension

Behavioral changes associated with economic development in the South Pacific: Health transition in Vanuatu

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