Disparities in Perceived Physical and Mental Wellness: Relationships Between Social Vulnerability, Cardiovascular Risk Factor Prevalence, and Health Behaviors Among Elderly US Residents

Introduction: Cardiovascular disease (CVD) is the leading cause of death for males, females, and people of most racial and ethnic groups in the United States. In addition to known epidemiological and behavioral risk factors, recent evidence suggests that circumstantial or behavioral factors may also be associated with CVD. This study evaluates the contribution of cardiovascular disease (CVD) risk factors, community vulnerabilities, and individual health behaviors to individual physical and mental wellness among Black and White, male, and female Medicare beneficiaries. Methods: This study utilized data from the Behavioral Risk Factor Surveillance System, county-level CVD risk factor prevalence, and selected items from the Social Vulnerability Index. Results: Correlations were found between unhealthy days reported by males and area social vulnerabilities and health behaviors. Prevalence of disease was correlated with mentally unhealthy days for White males. Among White females, health behaviors, disease prevalence, and social vulnerability measures were associated with unhealthy days. Among Black females, disease prevalence was highly correlated with mentally unhealthy days. Discussion: While individual-level health behaviors are highly associated with perceived physical and mental health, the self-reported health of Black respondents is also heavily correlated with local area vulnerabilities, including community poverty, group housing, and crowding.