ETHNIC AND GENDER DIFFERENCES IN PERCEPTIONS OF MORTALITY RISK Gilat L Grunau Pamela A Ratner Shahadut Hossain GENESIS: Gender and Sex Determinants of Cardiovascular Disease Background Cardiovascular disease in women – the numbers Cardiovascular disease in women – the perception Limitations of research to date Methods Random sample of men and women, 40 years of age and older, living in Vancouver (n=3,419) Administered in 4 languages: English, Punjabi, Mandarin, Cantonese Classification of ethnicity Questions 1. Heart disease is the most common cause of death in women in Canada (True or False?) 2. If false, what do you think is the most common cause of death in women? (Open ended, no response options provided) 3. Heart disease is the most common cause of death in men in Canada (True or False?) 4. If false, what do you think is the most common cause of death in men? (Open ended, no response options provided) Analysis Chi square Logistic regression for Questions 1 and 3. Independent variables: – Gender – Age – Ethnicity – Income – Education – History of acute myocardial infarction (AMI), either personally, in the family or among friends Results Of the 3,419: – 976 people completed the survey – 759 refused to participate – 1,684 people were found to be ineligible or could not be contacted. 185 (19.0)Missing 171 (17.5)$100,000 + 107 (11.0)$80,000 – $99,999 118 (12.1)$60,000 – $79,999 168 (17.1)$40,000 – $59,999 150 (15.4)$20,000 - $39,999 77 (7.9)$0-$19,999 Total household income (n (%)) 149 (15.3)Chinese (not born in Canada) 67 (6.9)South Asian (not born in Canada) 221 (22.7)Not born in Canada (Not Chinese/South Asian) 536 (55.1)Born in Canada Ethnicity (n (%)) 3 (0.3)Missing 548 (56.1)Female 425 (43.5)Male Gender (n (%)) 55.5 (11.1)Age (mean (SD) - years) 9 (0.9)Missing 693 (71.0)No 274 (28.1)Yes AMI history in self, family or friend (n (%)) 5 (0.5)Missing 294 (30.1)Baccalaureate or higher 342 (35.0)College/diploma/certificate/incomplete University 243 (24.9)High school 92 (9.4)< High school Education (n (%)) Heart disease most common cause of death in women FALSE TRUE "Don't know" 41.18% 48.47% 10.35% Men 37.77% 55.47% 6.75% Women Other causes of death for women – gender differences 0.00.2No response 2.74.2Don’t know 1.11.6Other (e.g., stroke, heart disease and cancer, cardiovascular disease, car accidents, stress, poverty ) 0.50.9“Old age” 0.70.0Ovarian cancer 0.01.9Lung cancer 16.117.2Breast cancer 16.615.1All cancers combined Percent of total women (n=548) Percent of total men (n=425) Heart disease most common cause of death in women – Ethnicity differences Born in Canada n=536 n (% of born in Canada) Not born in Canada (not Chinese/South Asian) n=221 n (% of not born in Canada, not Chinese/South Asian) South Asian n=67 n (% of South Asian) Chinese n=152 n (% of Chinese) True 330 (61.6) 116 (52.5) 30 (44.8) 35 (23.0) False 179 (33.4) 87 (39.4) 22 (32.8) 96 (63.2) Don’t know 27 (5.0) 18 (8.1) 15 (22.4) 21 (13.8) Logistic Regression Results For heart disease is the most common cause of death in men in Canada, none of the explanatory variables was found to be significant Knowing that heart disease is the most common cause of death in women was significantly associated with ethnicity Interactions of ethnicity with age and with gender were not significant for both outcomes Discussion Study included both men and women, can assess gender differences Significant ethnic differences in the participants’ understanding of the risk of heart disease mortality in women Responses for other causes of death for women raise concern Limitations and Implications Wording of question – vague or leading? Chinese community – why are they different? Women will need to see themselves as vulnerable to heart disease before they will be willing to adopt measures to prevent it Men will need to see the women in their lives as vulnerable to heart disease to help them take action to prevent it
NEXUS Spring Institute
Gender and ethnic differences in perceptions of mortality risk Grunau, Gilat; Ratner, Pamela; Hossain, Shahadut Apr 25, 2008
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