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Akioyamen LE, Ko DT, Cram P, Landon BE. Approaches to Comparing the Impact of Socioeconomic Disadvantage on Acute Myocardial Infarction Care Within and Across Countries: A Scoping Review. Can J Cardiol 2024; 40:1135-1145. [PMID: 38548014 PMCID: PMC11162914 DOI: 10.1016/j.cjca.2024.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/15/2024] [Accepted: 03/03/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Understanding how cardiovascular disease treatment and outcomes differ for socioeconomically disadvantaged patients across countries may reveal insights into the impact of countries' policy initiatives on health equity. However, methods of undertaking these studies are poorly characterized. METHODS We performed a scoping review to identify studies describing between-country comparisons of socioeconomic inequalities in the care of acute myocardial infarction (AMI). We sought to determine the extent to which such comparisons have been conducted, the methodologies used, and outcomes assessed. We searched Medline from January 1, 2013 to September 30, 2023 for peer-reviewed English-language publications. Studies were included if they stratified patients by a measure of socioeconomic disadvantage (eg, race, ethnicity, income, education, occupation, immigrant status) and made comparisons between 2 or more countries. RESULTS Our search yielded 4861 articles focused on patients with AMI, of which 7 met our inclusion criteria. Common individual-level proxies for disadvantage were self-reported income or education. In contrast, we found no cross-country comparisons focused on other measures of disadvantage such as race and ethnicity. There was marked heterogeneity in methods and thresholds used to define socioeconomic disadvantage at the individual level. All included studies found that patients with higher income and higher educational attainment had improved AMI outcomes. CONCLUSIONS Between-country comparisons of socioeconomic disparities in AMI outcomes are scarce and heterogeneous, but all identified studies relied on metrics of disadvantage including income and education that could be uniformly measured across countries. We found no articles addressing other types of inequities, likely because of significant methodologic challenges.
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Affiliation(s)
- Leo E Akioyamen
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Dennis T Ko
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Schulich Heart Program, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Peter Cram
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, UTMB, Galveston, Texas, USA
| | - Bruce E Landon
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA; Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
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Hassen HY, Abrams S, Musinguzi G, Rogers I, Dusabimana A, Mphekgwana PM, Bastiaens H. Disparities in the non-laboratory INTERHEART risk score and its components in selected countries of Europe and sub-Saharan Africa: analysis from the SPICES multi-country project. EUROPEAN HEART JOURNAL OPEN 2023; 3:oead131. [PMID: 38130418 PMCID: PMC10733186 DOI: 10.1093/ehjopen/oead131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/27/2023] [Accepted: 11/13/2023] [Indexed: 12/23/2023]
Abstract
Aims Accurate prediction of a person's risk of cardiovascular disease (CVD) is vital to initiate appropriate intervention. The non-laboratory INTERHEART risk score (NL-IHRS) is among the tools to estimate future risk of CVD. However, measurement disparities of the tool across contexts are not well documented. Thus, we investigated variation in NL-IHRS and components in selected sub-Saharan African and European countries. Methods and results We used data from a multi-country study involving 9309 participants, i.e. 4941 in Europe, 3371 in South Africa, and 997 in Uganda. Disparities in total NL-IHRS score, specific subcomponents, subcategories, and their contribution to the total score were investigated. The variation in the adjusted total and component scores was compared across contexts using analysis of variance. The adjusted mean NL-IHRS was higher in South Africa (10.2) and Europe (10.0) compared to Uganda (8.2), and the difference was statistically significant (P < 0.001). The prevalence and per cent contribution of diabetes mellitus and high blood pressure were lowest in Uganda. Score contribution of non-modifiable factors was lower in Uganda and South Africa, entailing 11.5% and 8.0% of the total score, respectively. Contribution of behavioural factors to the total score was highest in both sub-Saharan African countries. In particular, adjusted scores related to unhealthy dietary patterns were highest in South Africa (3.21) compared to Uganda (1.66) and Europe (1.09). Whereas, contribution of metabolic factors was highest in Europe (30.6%) compared with Uganda (20.8%) and South Africa (22.6%). Conclusion The total risk score, subcomponents, categories, and their contribution to total score greatly vary across contexts, which could be due to disparities in risk burden and/or self-reporting bias in resource-limited settings. Therefore, primary preventive initiatives should identify risk factor burden across contexts and intervention activities need to be customized accordingly. Furthermore, contextualizing the risk assessment tool and evaluating its usefulness in different settings are recommended.
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Affiliation(s)
- Hamid Y Hassen
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Doornstraat 331, Wilrijk 2610, Belgium
| | - Steven Abrams
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Doornstraat 331, Wilrijk 2610, Belgium
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Data Science Institute, Hasselt University, Diepenbeek 3590, Belgium
| | - Geofrey Musinguzi
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Doornstraat 331, Wilrijk 2610, Belgium
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, Uganda
| | - Imogen Rogers
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Alfred Dusabimana
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Doornstraat 331, Wilrijk 2610, Belgium
| | - Peter M Mphekgwana
- Research Administration and Development, University of Limpopo, Polokwane 0700, South Africa
| | - Hilde Bastiaens
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Doornstraat 331, Wilrijk 2610, Belgium
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Shaw S, Khan J. The risk of experiencing depression among older adults in India: A cross-sectional study. J Diabetes Metab Disord 2023; 22:629-638. [PMID: 37255784 PMCID: PMC10225437 DOI: 10.1007/s40200-023-01185-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 01/08/2023] [Indexed: 06/01/2023]
Abstract
Background The comorbidity of diabetes and depression poses a major challenge to older adults. While a few small scale studies have investigated the diabetes associated risk of experiencing depression, there is no national-level study available for India on the same. In this context, this study estimates the burden and risk of depression due to diabetes among older adults aged 45 and above in India while adjusting for socio-economic and demographic characteristics of the individuals. Methods Longitudinal Ageing Study in India (LASI), 2017-2018 wave 1 data was utilised in this study. The prevalence of depression and diabetes were estimated by background characteristics using bivariate cross-tabulation. In addition, multivariate logistic regression was applied to examine the likelihood of depression associated with diabetes and other covariates. Result Empirical estimation demonstrated that 14% of males and 8% of females with diabetes suffer from depression in the 45-59 age group. A diabetic person aged 45 and above was 16% more likely to suffer from depression than a non-diabetic person; whereas, a diabetic elderly aged 60 and above was 24% more likely to experience depression than their non-diabetic counterparts. The multivariate analysis confirmed a highly statistically significant association between diabetes and depression indicating a substantial risk to experience depression among those older adults and elderly who suffer from diabetes. Conclusion Elderly population (60 +) is at higher risk of experiencing depression due to diabetes. Therefore, public health care awareness should be raised, particularly among endocrinologists or specialist doctors who provide treatment at the tertiary-care hospitals in India. The health care experts should refer/recommend the diabetic patients to screen for depressive symptoms. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01185-6.
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Affiliation(s)
- Subhojit Shaw
- International Institute for Population Sciences, Deonar, 88 Mumbai, India
| | - Junaid Khan
- International Institute for Population Sciences, Deonar, 88 Mumbai, India
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Wang T, Li Y, Zheng X. Association of socioeconomic status with cardiovascular disease and cardiovascular risk factors: a systematic review and meta-analysis. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-15. [PMID: 36714072 PMCID: PMC9867543 DOI: 10.1007/s10389-023-01825-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 01/08/2023] [Indexed: 01/22/2023]
Abstract
Aim Cardiovascular disease (CVD) remains one of the leading causes of mortality worldwide, and several studies have indicated the association between socioeconomic status (SES) with CVD and cardiovascular risk factors (CVRFs). It is necessary to elucidate the association of SES and CVRFs with CVD. Subject and methods We searched PubMed, Embase, Web of Science, and the Cochrane Library for publications, using "socioeconomic status," "cardiovascular disease," and corresponding synonyms to obtain literature. The quality of studies was evaluated using the National Institutes of Health Quality Assessment Tool (NIH-QAT). All analyses were performed using Stata V.12.0. Results There were 31 eligible studies included in this meta-analysis. All studies presented a low risk of bias via NIH-QAT assessment. As for CVD incidence/mortality, pooled hazard ratios (HR) of low and middle vs. high income were [HR = 1.22 (1.17-1.28); HR = 1.12 (1.09-1.16)] and [HR = 1.37 (1.21-1.56); HR = 1.19 (1.06-1.34)]. The HR of education were [HR = 1.44 (1.28-1.63); HR = 1.2 (1.11-1.3)] and [HR = 1.5 (1.22-1.83); HR = 1.13 (1.05-1.22)]. The HR of deprivation were [HR = 1.28 (1.16-1.41); HR = 1.07 (1.03-1.11)] and [HR = 1.19 (1.11-1.29); HR = 1.1 (1.02-1.17)]. SES was negatively correlated with CVD outcomes. A subgroup analysis of gender and national income level also yielded a negative correlation, and additional details were also obtained. Conclusions SES is inversely correlated with CVD outcomes and the prevalence of CVRFs. As for CVD incidence, women may be more sensitive to income and education. In terms of CVD mortality, men may be more sensitive to income and education, and people from low- and middle-income countries are sensitive to income and education. Supplementary Information The online version contains supplementary material available at 10.1007/s10389-023-01825-4.
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Affiliation(s)
- Tao Wang
- School of Economics and Management, Southwest Petroleum University, NO. 8 Xindu Avenue, Xindu District, Chengdu City, Sichuan Province China
| | - Yilin Li
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaoqiang Zheng
- School of Economics and Management, Southwest Petroleum University, NO. 8 Xindu Avenue, Xindu District, Chengdu City, Sichuan Province China
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Zakaria SI, Alfian SD, Zakiyah N. Determinants of Cardiovascular Diseases in the Elderly Population in Indonesia: Evidence from Population-Based Indonesian Family Life Survey (IFLS). Vasc Health Risk Manag 2022; 18:905-914. [PMID: 36605931 PMCID: PMC9809171 DOI: 10.2147/vhrm.s390734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/13/2022] [Indexed: 12/31/2022] Open
Abstract
Introduction Cardiovascular disease (CVD) is the leading cause of death worldwide and is the number one mortality cause in Indonesia. The highest percentage of its prevalence occurs in the elderly population. This research aims to assess the determinants of CVDs in the elderly population in Indonesia based on the Indonesian Family Life Survey 5 (IFLS-5), a sub-nationally representative survey data, in 2014-2015. Methods A national cross-sectional population-based survey was conducted using multicenter data from approximately 13 provinces in Indonesia in 2014-2015. We included elderly subjects aged 60 years old and above with complete data on sociodemographic, smoking habits, obesity, dietary pattern, and physical activity and diagnosis data on hypertension, diabetes mellitus (DM), and hypercholesterolemia. Multivariate logistic regression was performed to estimate odds ratio (OR) and corresponding 95% confidence interval (95% CI) and p-value. Results We included complete data from 2873 respondents. The determinants associated with CVDs in the elderly population in Indonesia included college background (OR 6.26 [95% CI 2.690-14.613], p < 0.001), unemployment (OR 1.88 [95% CI 1.294-2.75], p = 0.001), urban population (OR 2.11 [95% CI 1.427-3.114], p < 0.001), obesity (OR 1.59 [95% CI 0.842-3.02], p = 0.152), low and medium physical activities (OR 2.34 [95% CI 1.335-4.121], p = 0.003 and OR 2.54 [95% CI 1.449-4.486], p = 0.001, respectively), hypertension (OR 4.25 [95% CI 2.945-6.137], p < 0.001), DM (OR 2.77 [95% CI 1.683-4.591], p < 0.001), and hypercholesterolemia (OR 2.99 [95% CI 1.860-4.812], p < 0.001). Conclusion The determinants of CVDs in the elderly population in Indonesia based on Indonesian Family Life Survey (IFLS)-5 data are hypertension, hypercholesterolemia, DM, lower physical activity, higher educational background, urban population, unemployment, and obesity. The findings of this current study highlight that more appropriate control measures such as tailored intervention by policymakers and healthcare providers for those at high risk should be initiated and implemented.
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Affiliation(s)
- Sri Intan Zakaria
- Pharmacist Professional Education Study Program, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, 45363, Indonesia,Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, 40132, Indonesia
| | - Sofa Dewi Alfian
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, 40132, Indonesia,Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, 40132, Indonesia
| | - Neily Zakiyah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, 40132, Indonesia,Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, 40132, Indonesia,Correspondence: Neily Zakiyah, Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, 40132, Indonesia, Tel/Fax +62-22-7796200, Email
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EDWARDS NM, KRISTIANSEN EB, VARNUM C, OVERGAARD S, NELISSEN RGHH, PEDERSEN AB. The association between socioeconomic status and the 90-day risk of cardiovascular events after total hip arthroplasty - registry-based study of 103,286 patients. Acta Orthop 2022; 93:837-848. [PMID: 36341544 PMCID: PMC9638845 DOI: 10.2340/17453674.2022.5253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND AND PURPOSE Patients receiving a total hip arthroplasty (THA) are subsequently at an increased risk of cardiovascular disease (CVD). Further, socioeconomic status (SES) has an effect on CVD. We evaluated whether low SES is associated with a higher risk of readmission due to CVD after THA within 90 days in a setting with universal tax-supported healthcare. PATIENTS AND METHODS We performed a nationwide population-based cohort study using Danish health registries from 1995 to 2017. Individual-based information on SES markers (cohabitation, education, income, and liquid assets) was obtained for all participants. The outcome was any hospital-treated CVD. The data was transformed using the pseudo-observation method to enable an estimation of the adjusted risk ratios (RRs) with 95% confidence intervals (CI) for each marker using generalized linear regression. RESULTS Among 103,286 THA patients, 452 were hospitalized with CVD within 90 days after surgery. Low SES seemed to be associated with a small increased risk of CVD, as the RRs for any CVD were 1.1 (95% CI 0.7-1.7) for patients living alone vs. cohabiting, 1.3 (CI 0.7- .3) for low education vs. high, 1.4 (CI 0.8-2.6) for low income vs. high, and 1.3 (CI 0.8-2.1) for low liquid assets vs. high. CONCLUSION Living alone, low education, low income, and low liquid assets seem to be associated with a small increased risk of readmission due to CVD 90 days after THA. Wide confidence intervals in risk should be considered when interpreting the study results.
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Affiliation(s)
- Nina M EDWARDS
- Department of Clinical Epidemiology, Aarhus University Hospital, Denmark,Department of Orthopaedic Surgery, Regionshospitalet Horsens, Denmark
| | | | - Claus VARNUM
- Department of Orthopaedic Surgery, Lillebaelt Hospital—Vejle, Denmark; Department of Regional Health Research, University of Southern Denmark, Denmark,Danish Hip Arthroplasty Register
| | - Søren OVERGAARD
- Danish Hip Arthroplasty Register,Department of Orthopaedic Surgery and Traumatology, Copenhagen University Hospital, Bispebjerg, University of Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, Denmark
| | - Rob G H H NELISSEN
- Department Orthopaedics, Leiden University Medical Center, Leiden, Netherlands
| | - Alma B PEDERSEN
- Department of Clinical Epidemiology, Aarhus University Hospital, Denmark,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Suliga E, Ciesla E, Lelonek M, Piechowska A, Gluszek S. Lifestyle elements and risk of metabolic syndrome in adults. PLoS One 2022; 17:e0275510. [PMID: 36178963 PMCID: PMC9524662 DOI: 10.1371/journal.pone.0275510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 09/19/2022] [Indexed: 11/20/2022] Open
Abstract
Background The aim of the study was to investigate which elements of lifestyle are associated with metabolic health in adults, defined as the absence of components of metabolic syndrome (MetS) based on the International Diabetes Federation criteria. Methods Data from 10,277 individuals aged 40–65 years constituted the material of this study. Univariate and multivariate analyses with backward stepwise selection were carried out to identify the factors associated with the absence of metabolic disorders. Results No family history of cardiovascular disease increased the odds of being metabolically healthy 1.5-2-fold. Furthermore, the following factors were associated with higher odds of being metabolically healthy in men: abstinence from alcohol (healthy individuals vs. those with ≥3 [OR = 5.49 (2.23–13.52); p<0.001], ≥2 [OR = 4.52 (1.87–10.91); p = 0.001], and ≥1 components of MetS [OR = 3.04 (1.41–6.56); p = 0.005]), moderate alcohol use (healthy individuals vs. those with ≥3 [OR = 3.36 (1.54–7.32); p = 0.002], ≥2 [OR = 3.28 (1.52–7.10); p = 0.002], and ≥1 components of MetS [OR = 3.93 (1.64–9.42); p = 0.002]), moderate-to-vigorous physical activity (MVPA) >2 hours/day and sitting time of 3–6 hours/day. Drinking >2 cups of coffee per day (healthy vs. those with ≥3 [OR = 2.00 (1.47–2.71)], ≥2 [OR = 1.84 (1.38–2.45)], and ≥1 components of MetS [OR = 1.72 (1.30–2.28); all p<0.001]), limiting animal fats to <2 servings/day, MVPA >2 hours/day, and 7–8 hours of sleep per day were associated with higher odds of being metabolically healthy in women. Conclusions A healthy lifestyle increased the odds of being metabolically healthy. Some lifestyle modifications may appear effective in prevention of not only MetS, but also single metabolic risk factors.
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Affiliation(s)
- Edyta Suliga
- Institute of Health Sciences, Medical College, Jan Kochanowski University, Kielce, Poland
| | - Elzbieta Ciesla
- Institute of Health Sciences, Medical College, Jan Kochanowski University, Kielce, Poland
| | - Magdalena Lelonek
- Institute of Health Sciences, Medical College, Jan Kochanowski University, Kielce, Poland
- * E-mail:
| | - Agnieszka Piechowska
- Institute of Medical Sciences, Medical College, Jan Kochanowski University, Kielce, Poland
| | - Stanislaw Gluszek
- Institute of Medical Sciences, Medical College, Jan Kochanowski University, Kielce, Poland
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Level of cardiovascular disease knowledge, risk perception and intention towards healthy lifestyle and socioeconomic disparities among adults in vulnerable communities of Belgium and England. BMC Public Health 2022; 22:197. [PMID: 35093056 PMCID: PMC8800212 DOI: 10.1186/s12889-022-12608-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 01/20/2022] [Indexed: 11/12/2022] Open
Abstract
Background The burden of cardiovascular diseases (CVDs) greatly varies between and within countries. Low- and middle-income countries (LMICs) and vulnerable communities of high-income countries (HIC) share disproportionately higher burden. Evidence is limited on the level of CVD knowledge and risk perception in vulnerable communities. Hence, in this study, we assessed the level of CVD knowledge, risk perception and change intention towards physical activity and healthy diet among vulnerable communities in Antwerp, Belgium and Nottingham, England. Furthermore, we investigated the socioeconomic disparities particularly in the Antwerp setting. Method A cross-sectional study was performed among 1,424 adults (958 in Antwerp and 466 in Nottingham) aged 18 or older among selected vulnerable communities. Districts or counties were selected based on socioeconomic and multiple deprivation index. A stratified random sampling was used in Antwerp, and purposive sampling in Nottingham. We determined the level of CVD knowledge, risk perception and intention towards a healthy lifestyle in Antwerp and Nottingham using a percentage score out of 100. To identify independent socioeconomic determinants in CVD knowledge, risk perception, intention to PA and healthy diet, we performed multilevel multivariable modeling using the Antwerp dataset. Results The mean knowledge percent score was 75.4 in Antwerp and 69.4 in Nottingham, and only 36.5% and 21.1% of participants respectively, had good CVD knowledge (scored 80% or above). In the multivariable analysis using the Antwerp dataset, level of education was significantly associated with (1) CVD knowledge score (Adjusted β = 0.11, 95%CI: 0.03, 0.18), (2) risk perception (0.23, 95%CI: 0.04, 0.41), (3) intention to physical activity (PA) (0.51, 95%CI: 0.35, 0.66), and (4) healthy diet intention (0.54, 95%CI: 0.32, 0.75). Furthermore, those individuals with a higher household income had a better healthy diet intention (0.44, 95%CI: 0.23, 0.65). In contrast, those who were of non-European origin scored lower on intention to have a healthy diet (-1.34, 95%CI:-2.07, -0.62) as compared to their European counterparts. On average, intention to PA was significantly higher among males (-0.43, 95%CI:-0.82, -0.03), whereas females scored better on healthy diet intention (2.02, 95%CI: 1.46, 2.57). Conclusions Knowledge towards CVD risks and prevention is low in vulnerable communities. Males have a higher intention towards PA while females towards a healthy diet and it also greatly varies across level of education. Moreover, those born outside Europe and with low household income have lower healthy diet intention than their respective counterparts. Hence, CVD preventive interventions should be participatory and based on a better understanding of the individuals’ socioeconomic status and cultural beliefs through active individual and community engagement. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12608-z.
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