Disparities in knowledge of heart attack and stroke symptoms among adult men: An analysis of behavioral risk factor surveillance survey data

Context: The staggering burden of myocardial infarction and stroke in men and for men of African-American descent in particular provided the impetus for this study. Morbidity and mortality from these vascular disorders can be reduced by early treatment, which requires correct prehospital identification of symptoms, Objective: The purpose of this study was to assess current knowledge of myocardial infarction and stroke symptoms and to examine if there were disparities in knowledge of these among D.S. males. Design: This is a cross-sectional study analyzing public use 2003-2005 Behavioral Risk Factor Surveillance Survey data. Univariate, bivariate and multivariate techniques were used. Setting: Random-digit-dial telephone survey focused on health risk factors and behaviors. Data collection was done under the direction of the Centers for Disease Control and Prevention. Patients or Other Participants: Data collections targeted noninstitutionalized U.S. adults 18-90 years of age. This study focused on the adult male population. Main Outcome Measures: From the 13 heart attack and stroke symptom knowledge questions asked on the survey, a heart attack and stroke knowledge score was computed for each respondent. Results: Multivariate analysis revealed that both Caucasian and African-American men earning low scores on the knowledge questions were more likely to: have less than a high-school education, have deferred medical care in the past 12 months because of cost and not have health insurance in the past 12 months. African-American men were also more likely to live in households with annual incomes <$35,000 and were more likely to not have a primary care provider; this was not true for Caucasian men. Conclusions: There is a disparity in myocardial infarction and stroke symptom knowledge along racial and socioeconomic lines. African-American mates, poorer individuals and those with lower levels of education had significantly lower scores. Since these subgroups are also among those at higher risk for stroke and myocardial infarction, targeting measures to enhance knowledge in these groups might yield more benefit than programs aimed at the general male populace.