Measuring demographic variables across groups to understand cardiovascular health among US adults

Cardiovascular disease is not equally distributed across ethnic and racial groups. Studies have shown that between and within-group disparities exist due to differences in social and economic positioning and related experiences. However, one underexplored area in social positioning is examining disparities based on demographic characteristics. For example, research across the Americas publish that different social categories result in a varied cardiovascular outcomes and wellbeing than others. Although all individuals embody both ethnicity and a race, for instance, research often flattens these varied experiences in favor of a single self-identification. How individuals self-identify is neither a linear process nor just influenced by individual-level factors. Different socialization experiences can produce differential exposures to risk thus producing distinct cardiovascular outcomes. For different communities, having robust measures of demographic variables remains as a gap. For instance, different communities such as Latinos, have high levels of missingness when using standard self-reported demographic questions, thus hindering our ability to investigate health disparities. This R03 study is informed by socialization and self-identity theories and uses qualitative and quantitative methods to begin addressing this gap in the literature and relatedly, our processes in data collection. This R03 proposal leverages results from an existing K01 study exploring self-identity among multiracial individuals and gaps on existing measurement of demographic variables to: (1) develop a multi-item demographic variable survey module, (2) evaluate the association between each demographic variable and cardiovascular risk factors, and (3) establish guidance on measuring demographics for different subgroups participating in research. For Aim 1, the study team will develop a demographic variable survey module comprised of existing items (i.e., questions) and novel items informed by the K01 study. The team will use cognitive interviews to assess the content validity of demographic variable survey module. For Aim 2, the study team will integrate the demographic variable survey module into a cross-sectional survey of cardiovascular risk factors for distribution to adults in the United States to assesses differences in cardiovascular risk across subgroups. For Aim 3, the study team will convene an advisory board to utilize R03 study results and existent literature to formulate guidance on best practices for using demographic questions in public health and medical research. The goals of this R03 study are consistent with the NHLBI’s strategic goals: (1) to investigate factors that account for differences in health among populations and (2) optimize clinical and implementation research to improve health and reduce disease. This proof-of-principle study will produce preliminary data on CVD disparities affecting US adults through the testing of a novel demographic variable survey module, which will inform tailored research studies to reduce health disparities between and within subgroups.