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Gender and ethnic differences in perceptions of mortality risk Grunau, Gilat 2009

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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

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