Evaluating the Reliability and Robustness of Racial and Ethnic Health Disparities in Cardiometabolic Disease in NHANES, NHIS, and BRFSS (2015–2021)

Background The United States uses the National Health Interview Survey (NHIS), Behavioral Risk Factor Surveillance System (BRFSS), and National Health and Nutrition Examination Survey to monitor disease trends and inform clinical care/prevention research. These 3 surveys share similar national estim...

Full description

Saved in:
Bibliographic Details
Main Authors: Zeel Thakkar, Yan Wu, Mohammed Khan, Xinran Qi, George A. Hung, Nicholas Kikuta, Armaan Jamal, Malathi Srinivasan, Robert J. Huang, Karina Kim, Gloria Kim, Latha Palaniappan, Adrian M. Bacong
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Subjects:
Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.124.040029
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849715480337580032
author Zeel Thakkar
Yan Wu
Mohammed Khan
Xinran Qi
George A. Hung
Nicholas Kikuta
Armaan Jamal
Malathi Srinivasan
Robert J. Huang
Karina Kim
Gloria Kim
Latha Palaniappan
Adrian M. Bacong
author_facet Zeel Thakkar
Yan Wu
Mohammed Khan
Xinran Qi
George A. Hung
Nicholas Kikuta
Armaan Jamal
Malathi Srinivasan
Robert J. Huang
Karina Kim
Gloria Kim
Latha Palaniappan
Adrian M. Bacong
author_sort Zeel Thakkar
collection DOAJ
description Background The United States uses the National Health Interview Survey (NHIS), Behavioral Risk Factor Surveillance System (BRFSS), and National Health and Nutrition Examination Survey to monitor disease trends and inform clinical care/prevention research. These 3 surveys share similar national estimates. However, the consistency of each survey's estimates by race has not been examined. Here, we compare prevalence estimates and disparities in cardiometabolic diseases across 5 aggregated racial and ethnic groups. Methods We examined the age‐ and fully‐adjusted prevalence of cardiovascular disease and diabetes among non‐Hispanic White, non‐Hispanic Black, Hispanic, non‐Hispanic Asian, and “Other” race respondents aged 30 years or older. Cardiovascular disease included self‐reported physician diagnosis of heart attack, stroke, and coronary heart disease. Results Although overall national population estimates were similar, there was heterogeneity in estimates by survey. For heart attack and diabetes, each racial group had a higher prevalence in BRFSS than NHIS (eg, Heart Attack: Hispanic BRFSS: 3.4% [95% CI, 3.2–3.6], NHIS: 2.0% [95% CI, 1.8, 2.2]; non‐Hispanic Black BRFSS: 3.8% [95% CI, 3.6, 3.9]; NHIS: 3.0% [95% CI, 2.7, 3.2]). Non‐Hispanic Asian people had the lowest general cardiovascular disease prevalence across all 3 data sets (NHIS: 5.9%, National Health and Nutrition Examination Survey: 5.3%, BRFSS: 6.9%), while Other/multi‐racial respondents had the highest prevalence (NHIS: 9.9%, National Health and Nutrition Examination Survey: 13.1%, BRFSS: 10.7%). However, the magnitude of these differences across data sets was small. Conclusions Prevalence estimates for heart attack and diabetes were heterogeneous by race across surveys. These results highlight the importance of improving the representation of racially minoritized groups within national surveys to produce more precise estimates.
format Article
id doaj-art-1dc8838c52bb4a9b96e17bccd0468357
institution DOAJ
issn 2047-9980
language English
publishDate 2025-03-01
publisher Wiley
record_format Article
series Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
spelling doaj-art-1dc8838c52bb4a9b96e17bccd04683572025-08-20T03:13:22ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-03-0114510.1161/JAHA.124.040029Evaluating the Reliability and Robustness of Racial and Ethnic Health Disparities in Cardiometabolic Disease in NHANES, NHIS, and BRFSS (2015–2021)Zeel Thakkar0Yan Wu1Mohammed Khan2Xinran Qi3George A. Hung4Nicholas Kikuta5Armaan Jamal6Malathi Srinivasan7Robert J. Huang8Karina Kim9Gloria Kim10Latha Palaniappan11Adrian M. Bacong12Stanford Center for Asian Health Research and Education Stanford University School of Medicine Stanford CAStanford Center for Asian Health Research and Education Stanford University School of Medicine Stanford CAStanford Center for Asian Health Research and Education Stanford University School of Medicine Stanford CAStanford Center for Asian Health Research and Education Stanford University School of Medicine Stanford CAStanford Center for Asian Health Research and Education Stanford University School of Medicine Stanford CAStanford Center for Asian Health Research and Education Stanford University School of Medicine Stanford CAStanford Center for Asian Health Research and Education Stanford University School of Medicine Stanford CAStanford Center for Asian Health Research and Education Stanford University School of Medicine Stanford CAStanford Center for Asian Health Research and Education Stanford University School of Medicine Stanford CAStanford Center for Asian Health Research and Education Stanford University School of Medicine Stanford CAStanford Center for Asian Health Research and Education Stanford University School of Medicine Stanford CAStanford Center for Asian Health Research and Education Stanford University School of Medicine Stanford CAStanford Center for Asian Health Research and Education Stanford University School of Medicine Stanford CABackground The United States uses the National Health Interview Survey (NHIS), Behavioral Risk Factor Surveillance System (BRFSS), and National Health and Nutrition Examination Survey to monitor disease trends and inform clinical care/prevention research. These 3 surveys share similar national estimates. However, the consistency of each survey's estimates by race has not been examined. Here, we compare prevalence estimates and disparities in cardiometabolic diseases across 5 aggregated racial and ethnic groups. Methods We examined the age‐ and fully‐adjusted prevalence of cardiovascular disease and diabetes among non‐Hispanic White, non‐Hispanic Black, Hispanic, non‐Hispanic Asian, and “Other” race respondents aged 30 years or older. Cardiovascular disease included self‐reported physician diagnosis of heart attack, stroke, and coronary heart disease. Results Although overall national population estimates were similar, there was heterogeneity in estimates by survey. For heart attack and diabetes, each racial group had a higher prevalence in BRFSS than NHIS (eg, Heart Attack: Hispanic BRFSS: 3.4% [95% CI, 3.2–3.6], NHIS: 2.0% [95% CI, 1.8, 2.2]; non‐Hispanic Black BRFSS: 3.8% [95% CI, 3.6, 3.9]; NHIS: 3.0% [95% CI, 2.7, 3.2]). Non‐Hispanic Asian people had the lowest general cardiovascular disease prevalence across all 3 data sets (NHIS: 5.9%, National Health and Nutrition Examination Survey: 5.3%, BRFSS: 6.9%), while Other/multi‐racial respondents had the highest prevalence (NHIS: 9.9%, National Health and Nutrition Examination Survey: 13.1%, BRFSS: 10.7%). However, the magnitude of these differences across data sets was small. Conclusions Prevalence estimates for heart attack and diabetes were heterogeneous by race across surveys. These results highlight the importance of improving the representation of racially minoritized groups within national surveys to produce more precise estimates.https://www.ahajournals.org/doi/10.1161/JAHA.124.040029Behavioral Risk Factor Surveillance Systemcardiometabolic diseasecardiovascular diseasemyocardial infarction/heart attackNational Health and Nutrition Examination SurveyNational Health Interview Survey
spellingShingle Zeel Thakkar
Yan Wu
Mohammed Khan
Xinran Qi
George A. Hung
Nicholas Kikuta
Armaan Jamal
Malathi Srinivasan
Robert J. Huang
Karina Kim
Gloria Kim
Latha Palaniappan
Adrian M. Bacong
Evaluating the Reliability and Robustness of Racial and Ethnic Health Disparities in Cardiometabolic Disease in NHANES, NHIS, and BRFSS (2015–2021)
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Behavioral Risk Factor Surveillance System
cardiometabolic disease
cardiovascular disease
myocardial infarction/heart attack
National Health and Nutrition Examination Survey
National Health Interview Survey
title Evaluating the Reliability and Robustness of Racial and Ethnic Health Disparities in Cardiometabolic Disease in NHANES, NHIS, and BRFSS (2015–2021)
title_full Evaluating the Reliability and Robustness of Racial and Ethnic Health Disparities in Cardiometabolic Disease in NHANES, NHIS, and BRFSS (2015–2021)
title_fullStr Evaluating the Reliability and Robustness of Racial and Ethnic Health Disparities in Cardiometabolic Disease in NHANES, NHIS, and BRFSS (2015–2021)
title_full_unstemmed Evaluating the Reliability and Robustness of Racial and Ethnic Health Disparities in Cardiometabolic Disease in NHANES, NHIS, and BRFSS (2015–2021)
title_short Evaluating the Reliability and Robustness of Racial and Ethnic Health Disparities in Cardiometabolic Disease in NHANES, NHIS, and BRFSS (2015–2021)
title_sort evaluating the reliability and robustness of racial and ethnic health disparities in cardiometabolic disease in nhanes nhis and brfss 2015 2021
topic Behavioral Risk Factor Surveillance System
cardiometabolic disease
cardiovascular disease
myocardial infarction/heart attack
National Health and Nutrition Examination Survey
National Health Interview Survey
url https://www.ahajournals.org/doi/10.1161/JAHA.124.040029
work_keys_str_mv AT zeelthakkar evaluatingthereliabilityandrobustnessofracialandethnichealthdisparitiesincardiometabolicdiseaseinnhanesnhisandbrfss20152021
AT yanwu evaluatingthereliabilityandrobustnessofracialandethnichealthdisparitiesincardiometabolicdiseaseinnhanesnhisandbrfss20152021
AT mohammedkhan evaluatingthereliabilityandrobustnessofracialandethnichealthdisparitiesincardiometabolicdiseaseinnhanesnhisandbrfss20152021
AT xinranqi evaluatingthereliabilityandrobustnessofracialandethnichealthdisparitiesincardiometabolicdiseaseinnhanesnhisandbrfss20152021
AT georgeahung evaluatingthereliabilityandrobustnessofracialandethnichealthdisparitiesincardiometabolicdiseaseinnhanesnhisandbrfss20152021
AT nicholaskikuta evaluatingthereliabilityandrobustnessofracialandethnichealthdisparitiesincardiometabolicdiseaseinnhanesnhisandbrfss20152021
AT armaanjamal evaluatingthereliabilityandrobustnessofracialandethnichealthdisparitiesincardiometabolicdiseaseinnhanesnhisandbrfss20152021
AT malathisrinivasan evaluatingthereliabilityandrobustnessofracialandethnichealthdisparitiesincardiometabolicdiseaseinnhanesnhisandbrfss20152021
AT robertjhuang evaluatingthereliabilityandrobustnessofracialandethnichealthdisparitiesincardiometabolicdiseaseinnhanesnhisandbrfss20152021
AT karinakim evaluatingthereliabilityandrobustnessofracialandethnichealthdisparitiesincardiometabolicdiseaseinnhanesnhisandbrfss20152021
AT gloriakim evaluatingthereliabilityandrobustnessofracialandethnichealthdisparitiesincardiometabolicdiseaseinnhanesnhisandbrfss20152021
AT lathapalaniappan evaluatingthereliabilityandrobustnessofracialandethnichealthdisparitiesincardiometabolicdiseaseinnhanesnhisandbrfss20152021
AT adrianmbacong evaluatingthereliabilityandrobustnessofracialandethnichealthdisparitiesincardiometabolicdiseaseinnhanesnhisandbrfss20152021