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CMAJ. May 2, 2000; 162(9): S5–S11.
PMCID: PMC1232442

Knowledge of cardiovascular disease risk factors among the Canadian population: relationships with indicators of socioeconomic status

Abstract

BACKGROUND: We examined the ability of adult Canadians to recall cardiovascular disease risk factors to determine the associations between their ability to recall risk factors for cardiovascular disease and their socioeconomic status. METHODS: This study used the database assembled by the Canadian Heart Health Surveys Research Group between 1986 and 1992--a stratified representative sample comprising 23,129 Canadian residents aged 18 to 74. Nurses administered a standard questionnaire asking respondents to list the major risk factors for cardiovascular disease: fat in food, smoking, lack of exercise, excess weight, elevated blood cholesterol and high blood pressure. Six logistic regressions examined the multivariate associations between ability to recall each risk factor with education, income adequacy, occupation, sex, age, marital status and province of residence. RESULTS: More people knew about the behaviour-related risk factors for cardiovascular disease than about the physiologic risk factors: 60% recalled fat in food, 52% smoking and 41% lack of exercise, but only 32% identified weight, 27% cholesterol and 22% high blood pressure. Education was the socioeconomic status indicator most strongly and consistently associated with the ability to recall risk factors for cardiovascular disease. The odds ratios of reporting an association of the risks between people with elementary education and those with university degrees varied between 0.16 (95% confidence interval 0.12 to 0.22) for lack of exercise to 0.55 (95% confidence interval 0.39 to 0.77) for smoking. INTERPRETATION: People in categories at greater risk of cardiovascular disease, such as those aged 65 or more or those with only elementary education, are less able to recall important cardiovascular disease risk factors.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Thom TJ. International mortality from heart disease: rates and trends. Int J Epidemiol. 1989;18(3 Suppl 1):S20–S28. [PubMed]
  • Higgins M, Thom T. Trends in CHD in the United States. Int J Epidemiol. 1989;18(3 Suppl 1):S58–S66. [PubMed]
  • Shea S, Basch CE. A review of five major community-based cardiovascular disease prevention programs. Part I: Rationale, design, and theoretical framework. Am J Health Promot. 1990 Jan-Feb;4(3):203–213. [PubMed]
  • Rosenstock IM. Adoption and maintenance of lifestyle modifications. Am J Prev Med. 1988 Nov-Dec;4(6):349–352. [PubMed]
  • Janz NK, Becker MH. The Health Belief Model: a decade later. Health Educ Q. 1984 Spring;11(1):1–47. [PubMed]
  • Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977 Mar;84(2):191–215. [PubMed]
  • Maccoby N, Farquhar JW, Wood PD, Alexander J. Reducing the risk of cardiovascular disease: effects of a community-based campaign on knowledge and behavior. J Community Health. 1977 Winter;3(2):100–114. [PubMed]
  • Osler M, Lous J, Rasmussen NK. Knowledge, attitudes and cardiovascular risk factors in Danish adults. Scand J Soc Med. 1992 Sep;20(3):151–157. [PubMed]
  • Winkleby MA, Fortmann SP, Barrett DC. Social class disparities in risk factors for disease: eight-year prevalence patterns by level of education. Prev Med. 1990 Jan;19(1):1–12. [PubMed]
  • Frank E, Winkleby MA, Fortmann SP, Rockhill B, Farquhar JW. Improved cholesterol-related knowledge and behavior and plasma cholesterol levels in adults during the 1980s. JAMA. 1992 Sep 23;268(12):1566–1572. [PubMed]
  • Shea S, Stein AD, Basch CE, Lantigua R, Maylahn C, Strogatz DS, Novick L. Independent associations of educational attainment and ethnicity with behavioral risk factors for cardiovascular disease. Am J Epidemiol. 1991 Sep 15;134(6):567–582. [PubMed]
  • Shekelle RB, Liu SC. Public beliefs about causes and prevention of heart attacks. JAMA. 1978 Aug 25;240(8):756–758. [PubMed]
  • Folsom AR, Sprafka JM, Luepker RV, Jacobs DR., Jr Beliefs among black and white adults about causes and prevention of cardiovascular disease: the Minnesota Heart Survey. Am J Prev Med. 1988 May-Jun;4(3):121–127. [PubMed]
  • Ford ES, Jones DH. Cardiovascular health knowledge in the United States: findings from the National Health Interview Survey, 1985. Prev Med. 1991 Nov;20(6):725–736. [PubMed]
  • Haines CM, Ward GW. Recent trends in public knowledge, attitudes, and reported behavior with respect to high blood pressure. Public Health Rep. 1981 Nov-Dec;96(6):514–522. [PMC free article] [PubMed]
  • Heimbach JT. Cardiovascular disease and diet: the public view. Public Health Rep. 1985 Jan-Feb;100(1):5–12. [PMC free article] [PubMed]
  • Schucker B, Bailey K, Heimbach JT, Mattson ME, Wittes JT, Haines CM, Gordon DJ, Cutler JA, Keating VS, Goor RS, et al. Change in public perspective on cholesterol and heart disease. Results from two national surveys. JAMA. 1987 Dec 25;258(24):3527–3531. [PubMed]
  • Schucker B, Wittes JT, Santanello NC, Weber SJ, McGoldrick D, Donato K, Levy A, Rifkind BM. Change in cholesterol awareness and action. Results from national physician and public surveys. Arch Intern Med. 1991 Apr;151(4):666–673. [PubMed]
  • Avis NE, McKinlay JB, Smith KW. Is cardiovascular risk factor knowledge sufficient to influence behavior? Am J Prev Med. 1990 May-Jun;6(3):137–144. [PubMed]
  • Winkleby MA, Jatulis DE, Frank E, Fortmann SP. Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health. 1992 Jun;82(6):816–820. [PMC free article] [PubMed]
  • MacLean DR, Petrasovits A, Nargundkar M, Connelly PW, MacLeod E, Edwards A, Hessel P. Canadian heart health surveys: a profile of cardiovascular risk. Survey methods and data analysis. Canadian Heart Health Surveys Research Group. CMAJ. 1992 Jun 1;146(11):1969–1974. [PMC free article] [PubMed]
  • Bettinghaus EP. Health promotion and the knowledge-attitude-behavior continuum. Prev Med. 1986 Sep;15(5):475–491. [PubMed]
  • Adler NE, Boyce T, Chesney MA, Cohen S, Folkman S, Kahn RL, Syme SL. Socioeconomic status and health. The challenge of the gradient. Am Psychol. 1994 Jan;49(1):15–24. [PubMed]
  • Green LW, Richard L. The need to combine health education and health promotion: the case of cardiovascular disease prevention. Promot Educ. 1993 Dec;Spec No:11–18. [PubMed]
  • Raeburn J, Beaglehole R. Health promotion: can it redress the health effects of social disadvantage? Community Health Stud. 1989;13(3):289–293. [PubMed]
  • Nair C, Colburn H, McLean D, Petrasovits A. Cardiovascular disease in Canada. Health Rep. 1989;1(1):1–22. [PubMed]
  • Pocock SJ, Shaper AG, Cook DG, Phillips AN, Walker M. Social class differences in ischaemic heart disease in British men. Lancet. 1987 Jul 25;2(8552):197–201. [PubMed]
  • Siegel PZ, Deeb LC, Wolfe LE, Wilcox D, Marks JS. Stroke mortality and its socioeconomic, racial, and behavioral correlates in Florida. Public Health Rep. 1993 Jul-Aug;108(4):454–458. [PMC free article] [PubMed]
  • Gold MR, Franks P. The social origin of cardiovascular risk: an investigation in a rural community. Int J Health Serv. 1990;20(3):405–416. [PubMed]
  • Winkleby MA, Fortmann SP, Barrett DC. Social class disparities in risk factors for disease: eight-year prevalence patterns by level of education. Prev Med. 1990 Jan;19(1):1–12. [PubMed]
  • Millar WJ, Stephens T. Social status and health risks in Canadian adults: 1985 and 1991. Health Rep. 1993;5(2):143–156. [PubMed]
  • Winkleby MA, Jatulis DE, Frank E, Fortmann SP. Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health. 1992 Jun;82(6):816–820. [PMC free article] [PubMed]
  • Johnson JL, Heineman EF, Heiss G, Hames CG, Tyroler HA. Cardiovascular disease risk factors and mortality among black women and white women aged 40-64 years in Evans County, Georgia. Am J Epidemiol. 1986 Feb;123(2):209–220. [PubMed]
  • Millar WJ, Wigle DT. Socioeconomic disparities in risk factors for cardiovascular disease. CMAJ. 1986 Jan 15;134(2):127–132. [PMC free article] [PubMed]
  • Winkleby MA, Fortmann SP, Rockhill B. Health-related risk factors in a sample of Hispanics and whites matched on sociodemographic characteristics. The Stanford Five-City Project. Am J Epidemiol. 1993 Jun 15;137(12):1365–1375. [PubMed]
  • Nieto FJ, Szklo M, Folsom AR, Rock R, Mercuri M. Leukocyte count correlates in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Epidemiol. 1992 Sep 1;136(5):525–537. [PubMed]
  • Petri M, Spence D, Bone LR, Hochberg MC. Coronary artery disease risk factors in the Johns Hopkins Lupus Cohort: prevalence, recognition by patients, and preventive practices. Medicine (Baltimore) 1992 Sep;71(5):291–302. [PubMed]
  • Shaper AG, Phillips AN, Pocock SJ, Walker M, Macfarlane PW. Risk factors for stroke in middle aged British men. BMJ. 1991 May 11;302(6785):1111–1115. [PMC free article] [PubMed]
  • Kaplan GA, Cohn BA, Cohen RD, Guralnik J. The decline in ischemic heart disease mortality: prospective evidence from the Alameda County Study. Am J Epidemiol. 1988 Jun;127(6):1131–1142. [PubMed]
  • Luepker RV, Jacobs DR, Gillum RF, Folsom AR, Prineas RJ, Blackburn H. Population risk of cardiovascular disease: the Minnesota Heart Survey. J Chronic Dis. 1985;38(8):671–682. [PubMed]
  • Hazuda HP, Haffner SM, Stern MP, Knapp JA, Eifler CW, Rosenthal M. Employment status and women's protection against coronary heart disease. Findings from the San Antonio Heart Study. Am J Epidemiol. 1986 Apr;123(4):623–640. [PubMed]
  • MacDonald S, Joffres MR, Stachenko S, Horlick L, Fodor G. Multiple cardiovascular disease risk factors in Canadian adults. Canadian Heart Health Surveys Research Group. CMAJ. 1992 Jun 1;146(11):2021–2029. [PMC free article] [PubMed]
  • Wigle DT, Mao Y, Semenciw R, McCann C, Davies JW. Premature deaths in Canada: impact, trends and opportunities for prevention. Can J Public Health. 1990 Sep-Oct;81(5):376–381. [PubMed]
  • Wilkins R, Adams O, Brancker A. Changes in mortality by income in urban Canada from 1971 to 1986. Health Rep. 1989;1(2):137–174. [PubMed]
  • Marmot MG, McDowall ME. Mortality decline and widening social inequalities. Lancet. 1986 Aug 2;2(8501):274–276. [PubMed]
  • Starrin B, Hagquist C, Larsson G, Svensson PG. Community types, socio-economic structure and IHD mortality--a contextual analysis based on Swedish aggregate data. Soc Sci Med. 1993 Jun;36(12):1569–1578. [PubMed]
  • Marmot MG, Kogevinas M, Elston MA. Social/economic status and disease. Annu Rev Public Health. 1987;8:111–135. [PubMed]
  • Keil JE, Sutherland SE, Knapp RG, Tyroler HA. Does equal socioeconomic status in black and white men mean equal risk of mortality? Am J Public Health. 1992 Aug;82(8):1133–1136. [PMC free article] [PubMed]
  • Keil JE, Sutherland SE, Knapp RG, Lackland DT, Gazes PC, Tyroler HA. Mortality rates and risk factors for coronary disease in black as compared with white men and women. N Engl J Med. 1993 Jul 8;329(2):73–78. [PubMed]
  • Garrison RJ, Gold RS, Wilson PW, Kannel WB. Educational attainment and coronary heart disease risk: the Framingham Offspring Study. Prev Med. 1993 Jan;22(1):54–64. [PubMed]
  • Jacobsen BK, Thelle DS. Risk factors for coronary heart disease and level of education. The Tromsø Heart Study. Am J Epidemiol. 1988 May;127(5):923–932. [PubMed]
  • Reynes JF, Lasater TM, Feldman H, Assaf AR, Carleton RA. Education and risk factors for coronary heart disease: results from a New England community. Am J Prev Med. 1993 Nov-Dec;9(6):365–371. [PubMed]
  • Williams RB, Barefoot JC, Califf RM, Haney TL, Saunders WB, Pryor DB, Hlatky MA, Siegler IC, Mark DB. Prognostic importance of social and economic resources among medically treated patients with angiographically documented coronary artery disease. JAMA. 1992 Jan 22;267(4):520–524. [PubMed]
  • Stunkard AJ, Sørensen TI. Obesity and socioeconomic status--a complex relation. N Engl J Med. 1993 Sep 30;329(14):1036–1037. [PubMed]
  • Hebert PR, Buring JE, O'Connor GT, Rosner B, Hennekens CH. Occupation and risk of nonfatal myocardial infarction. Arch Intern Med. 1992 Nov;152(11):2253–2257. [PubMed]
  • MacLean DR, Petrasovits A, Nargundkar M, Connelly PW, MacLeod E, Edwards A, Hessel P. Canadian heart health surveys: a profile of cardiovascular risk. Survey methods and data analysis. Canadian Heart Health Surveys Research Group. CMAJ. 1992 Jun 1;146(11):1969–1974. [PMC free article] [PubMed]
  • Connelly PW, MacLean DR, Horlick L, O'Connor B, Petrasovits A, Little JA. Plasma lipids and lipoproteins and the prevalence of risk for coronary heart disease in Canadian adults. Canadian Heart Health Surveys Research Group. CMAJ. 1992 Jun 1;146(11):1977–1987. [PMC free article] [PubMed]
  • Stachenko SJ, Reeder BA, Lindsay E, Donovan C, Lessard R, Balram C. Smoking prevalence and associated risk factors in Canadian adults. Canadian Heart Health Surveys Research Group. CMAJ. 1992 Jun 1;146(11):1989–1996. [PMC free article] [PubMed]
  • Joffres MR, Hamet P, Rabkin SW, Gelskey D, Hogan K, Fodor G. Prevalence, control and awareness of high blood pressure among Canadian adults. Canadian Heart Health Surveys Research Group. CMAJ. 1992 Jun 1;146(11):1997–2005. [PMC free article] [PubMed]
  • Reeder BA, Angel A, Ledoux M, Rabkin SW, Young TK, Sweet LE. Obesity and its relation to cardiovascular disease risk factors in Canadian adults. Canadian Heart Health Surveys Research Group. CMAJ. 1992 Jun 1;146(11):2009–2019. [PMC free article] [PubMed]
  • Tomiak M, Gentleman JF. Risk factors for hypertension as measured by the Canada Health Survey. Health Rep. 1993;5(4):419–428. [PubMed]
  • Peto R, Lopez AD, Boreham J, Thun M, Heath C., Jr Mortality from tobacco in developed countries: indirect estimation from national vital statistics. Lancet. 1992 May 23;339(8804):1268–1278. [PubMed]
  • Mao Y, Gibbons L, Wong T. The impact of the decreased prevalence of smoking in Canada. Can J Public Health. 1992 Nov-Dec;83(6):413–416. [PubMed]

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