2022
The Impact of the Affordable Care Act on Disparities in Utilization of Cardiovascular Preventive Services by Socioeconomic Status
Verma H, Javed Z, Hong JC, Mahajan S, Mszar R, Grandhi GR, Desai NR, Virani SS, Javed U, Valero-Elizondo J, Nasir K. The Impact of the Affordable Care Act on Disparities in Utilization of Cardiovascular Preventive Services by Socioeconomic Status. Population Health Management 2022, 25: 669-676. PMID: 36067118, DOI: 10.1089/pop.2021.0337.Peer-Reviewed Original ResearchConceptsPreventive servicesSocioeconomic statusAffordable Care ActNational Health Interview SurveyBlood pressure checkSmoking cessation adviceCare ActHealth Interview SurveyVulnerable population subgroupsCardiovascular preventive servicesCessation adviceGlycemic screeningCardiovascular outcomesCholesterol checkBlood pressurePressure checkStudy populationUS adultsCare disparitiesSES disparitiesSES groupStudy periodInterview SurveyPopulation subgroupsSignificant decreaseTemporal Trends in Racial and Ethnic Disparities in Multimorbidity Prevalence in the United States, 1999-2018
Caraballo C, Herrin J, Mahajan S, Massey D, Lu Y, Ndumele CD, Drye EE, Krumholz HM. Temporal Trends in Racial and Ethnic Disparities in Multimorbidity Prevalence in the United States, 1999-2018. The American Journal Of Medicine 2022, 135: 1083-1092.e14. PMID: 35472394, DOI: 10.1016/j.amjmed.2022.04.010.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultChronic DiseaseCross-Sectional StudiesEthnicityHumansMultimorbidityPrevalenceUnited StatesConceptsMultimorbidity prevalenceRace/ethnicityWhite individualsChronic conditionsBlack individualsSerial cross-sectional analysisCommon chronic conditionsRisk of morbidityPrevalence of multimorbidityPublic health interventionsCross-sectional analysisSelf-reported presenceSelf-reported raceLatino/HispanicMAIN OUTCOMEHealth interventionsEthnic disparitiesPrevalenceHealth inequalitiesStudy periodEarly lifeHispanic individualsTemporal trendsStudy sampleAsian individualsSocial determinants of health and obesity: Findings from a national study of US adults
Javed Z, Valero‐Elizondo J, Maqsood MH, Mahajan S, Taha MB, Patel KV, Sharma G, Hagan K, Blaha MJ, Blankstein R, Mossialos E, Virani SS, Cainzos‐Achirica M, Nasir K. Social determinants of health and obesity: Findings from a national study of US adults. Obesity 2022, 30: 491-502. PMID: 35088551, DOI: 10.1002/oby.23336.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultHumansMiddle AgedObesityOverweightSocial Determinants of HealthUnited StatesConceptsOverweight/obesitySocial determinantsNon-Hispanic black adultsNational Health Interview SurveyObesity class 1Prevalence of overweightObesity class 3Odds of obesityHealth Interview SurveyHigher relative prevalenceCumulative social disadvantageLogistic regression modelsRace/ethnicityMultinomial logistic regression modelsObesity prevalenceHealth burdenUS adultsObesityObesity ratesBlack adultsOverweightRelevant covariatesInterview SurveyQuartilePrevalenceSocial Determinants of Suboptimal Cardiovascular Health Among Pregnant Women in the United States
Sharma G, Grandhi GR, Acquah I, Mszar R, Mahajan S, Khan SU, Javed Z, Mehta LS, Gulati M, Cainzos‐Achirica M, Blumenthal RS, Nasir K. Social Determinants of Suboptimal Cardiovascular Health Among Pregnant Women in the United States. Journal Of The American Heart Association 2022, 11: e022837. PMID: 35014862, PMCID: PMC9238529, DOI: 10.1161/jaha.121.022837.Peer-Reviewed Original ResearchConceptsSuboptimal cardiovascular healthInsufficient physical activityPregnant womenCardiovascular healthAssociation of SDOHRisk factorsPhysical activitySocial determinantsNational Health Interview SurveyModifiable risk factorsPublic health urgencyHealth Interview SurveyDisadvantaged pregnant womenPoisson regression modelsMaternal morbidityRisk ratioFirst quartileSDOHInterview SurveyCross-sectional dataWomenQuartileRegression modelsHealthUnited States
2021
Delayed medical care due to transportation barriers among adults with atherosclerotic cardiovascular disease
Acquah I, Hagan K, Valero-Elizondo J, Javed Z, Butt SA, Mahajan S, Taha MB, Hyder AA, Mossialos E, Cainzos-Achirica M, Nasir K. Delayed medical care due to transportation barriers among adults with atherosclerotic cardiovascular disease. American Heart Journal 2021, 245: 60-69. PMID: 34902312, DOI: 10.1016/j.ahj.2021.11.019.Peer-Reviewed Original ResearchMeSH KeywordsAtherosclerosisCardiovascular DiseasesFemaleHumansIncomeMedicaidPovertyUnited StatesYoung AdultConceptsAtherosclerotic cardiovascular diseaseTransportation barriersCardiovascular diseaseMedical careSociodemographic characteristicsNon-Hispanic black adultsNational Health Interview SurveyHealth Interview SurveySelf-reported prevalenceUse of telehealthMedicaid insuranceU.S. patientsHigher oddsProvision of transportationMobile clinicsPatientsBlack adultsLogistic regressionYoung adultsInterview SurveyCareYoung individualsAdultsVulnerable groupsDiseaseNational Trends in Racial and Ethnic Disparities in Antihypertensive Medication Use and Blood Pressure Control Among Adults With Hypertension, 2011–2018
Lu Y, Liu Y, Dhingra LS, Massey D, Caraballo C, Mahajan S, Spatz ES, Onuma O, Herrin J, Krumholz HM. National Trends in Racial and Ethnic Disparities in Antihypertensive Medication Use and Blood Pressure Control Among Adults With Hypertension, 2011–2018. Hypertension 2021, 79: 207-217. PMID: 34775785, DOI: 10.1161/hypertensionaha.121.18381.Peer-Reviewed Original ResearchConceptsAntihypertensive medication usePoor hypertension controlOverall treatment rateLow control rateHypertension controlHypertension awarenessMedication useControl rateHispanic individualsEthnic differencesTreatment ratesBlack individualsGuideline-recommended medicationsBlood pressure controlWhite individualsNutrition Examination SurveyLow awareness rateAntihypertensive medicationsHypertensive peopleExamination SurveyIntensive medicationNational HealthAwareness rateEthnic disparitiesPressure controlTracking Self-reported Symptoms and Medical Conditions on Social Media During the COVID-19 Pandemic: Infodemiological Study
Ding Q, Massey D, Huang C, Grady CB, Lu Y, Cohen A, Matzner P, Mahajan S, Caraballo C, Kumar N, Xue Y, Dreyer R, Roy B, Krumholz HM. Tracking Self-reported Symptoms and Medical Conditions on Social Media During the COVID-19 Pandemic: Infodemiological Study. JMIR Public Health And Surveillance 2021, 7: e29413. PMID: 34517338, PMCID: PMC8480398, DOI: 10.2196/29413.Peer-Reviewed Original ResearchTrends in Differences in Health Status and Health Care Access and Affordability by Race and Ethnicity in the United States, 1999-2018
Mahajan S, Caraballo C, Lu Y, Valero-Elizondo J, Massey D, Annapureddy AR, Roy B, Riley C, Murugiah K, Onuma O, Nunez-Smith M, Forman HP, Nasir K, Herrin J, Krumholz HM. Trends in Differences in Health Status and Health Care Access and Affordability by Race and Ethnicity in the United States, 1999-2018. JAMA 2021, 326: 637-648. PMID: 34402830, PMCID: PMC8371573, DOI: 10.1001/jama.2021.9907.Peer-Reviewed Original ResearchConceptsHealth care accessFair health statusSelf-reported health statusCare accessHealth statusWhite individualsEthnic differencesLatino/HispanicNational Health Interview Survey dataSerial cross-sectional studySelf-reported functional limitationsBlack individualsHealth Interview Survey dataLow incomeCross-sectional studyCross-sectional survey studyInterview Survey dataSelf-reported raceSelf-report measuresMAIN OUTCOMEUS adultsFunctional limitationsPercentage of peopleSignificant decreaseAdultsScope and Social Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United States
Mahajan S, Grandhi GR, Valero‐Elizondo J, Mszar R, Khera R, Acquah I, Yahya T, Virani SS, Blankstein R, Blaha MJ, Cainzos‐Achirica M, Nasir K. Scope and Social Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United States. Journal Of The American Heart Association 2021, 10: e020028. PMID: 34387089, PMCID: PMC8475063, DOI: 10.1161/jaha.120.020028.Peer-Reviewed Original ResearchConceptsHigh-risk characteristicsUS adultsNational Health Interview Survey dataHealth Interview Survey dataAtherosclerotic cardiovascular diseaseCoronary heart diseaseSelf-reported diagnosisNon-Hispanic blacksInterview Survey dataFood Security Survey ModuleCardiovascular disease resultsLow family incomeAdult Food Security Survey ModuleFood insecurityHeart diseaseASCVDCardiovascular diseasePocket healthcare expenditureHigher oddsSociodemographic determinantsDisease resultsStudy participantsSocial determinantsHealthcare expendituresSociodemographic subgroupsEngagement With COVID-19 Public Health Measures in the United States: A Cross-sectional Social Media Analysis from June to November 2020
Massey D, Huang C, Lu Y, Cohen A, Oren Y, Moed T, Matzner P, Mahajan S, Caraballo C, Kumar N, Xue Y, Ding Q, Dreyer R, Roy B, Krumholz H. Engagement With COVID-19 Public Health Measures in the United States: A Cross-sectional Social Media Analysis from June to November 2020. Journal Of Medical Internet Research 2021, 23: e26655. PMID: 34086593, PMCID: PMC8218897, DOI: 10.2196/26655.Peer-Reviewed Original Research
2020
Associations Between the Severity of Influenza Seasons and Mortality and Readmission Risks After Elective Surgical Aortic Valve Replacement and Coronary Artery Bypass Graft Surgery in Older Adults
Mori M, Wang Y, Mahajan S, Geirsson A, Krumholz HM. Associations Between the Severity of Influenza Seasons and Mortality and Readmission Risks After Elective Surgical Aortic Valve Replacement and Coronary Artery Bypass Graft Surgery in Older Adults. JAMA Network Open 2020, 3: e2031078. PMID: 33355673, PMCID: PMC7758803, DOI: 10.1001/jamanetworkopen.2020.31078.Peer-Reviewed Original ResearchConceptsSurgical aortic valve replacementElective surgical aortic valve replacementAortic valve replacementValve replacementReadmission riskCoronary artery bypass graft surgeryArtery bypass graft surgeryOlder adultsBypass graft surgeryCoronary artery bypassCross-sectional studyArtery bypassGraft surgeryInfluenza seasonMedicaid ServicesMortalitySeverityAdultsRiskAssociationSurgeryBypassDisparities in cholesterol screening among a nationally representative sample of pregnant women in the United States
Mszar R, Mahajan S, Valero-Elizondo J, Grandhi GR, Caraballo C, Gopal DJ, Nemiroff RL, Soffer DE, Cainzos-Achirica M, Sharma G, Nasir K. Disparities in cholesterol screening among a nationally representative sample of pregnant women in the United States. European Journal Of Preventive Cardiology 2020, 29: e11-e13. PMID: 33624106, DOI: 10.1093/eurjpc/zwaa100.Peer-Reviewed Original ResearchAssociation Between Sociodemographic Determinants and Disparities in Stroke Symptom Awareness Among US Young Adults
Mszar R, Mahajan S, Valero-Elizondo J, Yahya T, Sharma R, Grandhi GR, Khera R, Virani SS, Lichtman J, Khan SU, Cainzos-Achirica M, Vahidy FS, Krumholz HM, Nasir K. Association Between Sociodemographic Determinants and Disparities in Stroke Symptom Awareness Among US Young Adults. Stroke 2020, 51: 3552-3561. PMID: 33100188, DOI: 10.1161/strokeaha.120.031137.Peer-Reviewed Original ResearchConceptsNational Health Interview SurveyCommon stroke symptomsStroke symptomsHealth Interview SurveyYoung adultsUS young adultsSymptom awarenessFocused public health interventionsInterview SurveyStroke symptom awarenessHigh-risk characteristicsPublic health interventionsArms/legsCertain sociodemographic subgroupsLow education levelStroke incidenceSevere headacheSingle symptomStudy populationTimely diagnosisHigher oddsStroke rateHispanic ethnicityGeneral populationSociodemographic determinantsTrends and Predictors of Use of Digital Health Technology in the United States
Mahajan S, Lu Y, Spatz ES, Nasir K, Krumholz HM. Trends and Predictors of Use of Digital Health Technology in the United States. The American Journal Of Medicine 2020, 134: 129-134. PMID: 32717188, DOI: 10.1016/j.amjmed.2020.06.033.Peer-Reviewed Original ResearchBurden and Consequences of Financial Hardship From Medical Bills Among Nonelderly Adults With Diabetes Mellitus in the United States
Caraballo C, Valero-Elizondo J, Khera R, Mahajan S, Grandhi GR, Virani SS, Mszar R, Krumholz HM, Nasir K. Burden and Consequences of Financial Hardship From Medical Bills Among Nonelderly Adults With Diabetes Mellitus in the United States. Circulation Cardiovascular Quality And Outcomes 2020, 13: e006139. PMID: 32069093, DOI: 10.1161/circoutcomes.119.006139.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge FactorsBlack or African AmericanComorbidityCost of IllnessCross-Sectional StudiesDiabetes MellitusFemaleFinancing, PersonalFood SupplyHealth Care CostsHealth Care SurveysHealth ExpendituresHealth Services AccessibilityHumansIncomeMaleMedically UninsuredMiddle AgedPatient ComplianceRisk AssessmentRisk FactorsUnited StatesYoung AdultConceptsDiabetes mellitusMedical billsHigher oddsMedical careNational Health Interview Survey dataHealth Interview Survey dataCost-related medication nonadherenceHigher comorbidity burdenCost-related nonadherenceSelf-reported diagnosisNon-Hispanic blacksInterview Survey dataFinancial hardshipMedication nonadherenceMean ageNonmedical needsHigh prevalenceMellitusMultivariate analysisPocket expenditureFood insecurityNonadherenceHigh financial distressPatientsAdults
2019
Variation and Disparities in Awareness of Myocardial Infarction Symptoms Among Adults in the United States
Mahajan S, Valero-Elizondo J, Khera R, Desai NR, Blankstein R, Blaha MJ, Virani SS, Kash BA, Zoghbi WA, Krumholz HM, Nasir K. Variation and Disparities in Awareness of Myocardial Infarction Symptoms Among Adults in the United States. JAMA Network Open 2019, 2: e1917885. PMID: 31851350, PMCID: PMC6991230, DOI: 10.1001/jamanetworkopen.2019.17885.Peer-Reviewed Original ResearchConceptsMyocardial infarction symptomsShortness of breathMyocardial infarctionInfarction symptomsLow education levelEmergency medical servicesChest painSociodemographic subgroupsNational Health Interview SurveyEmergency cardiac careCross-sectional studyMedical servicesHealth Interview SurveyPublic health initiativesEducation levelLow-income subgroupsPrompt recognitionBack painCommon symptomsMale sexCardiac careHigher oddsHispanic ethnicityMAIN OUTCOMEHigh riskDevelopment and Testing of Improved Models to Predict Payment Using Centers for Medicare & Medicaid Services Claims Data
Krumholz HM, Warner F, Coppi A, Triche EW, Li SX, Mahajan S, Li Y, Bernheim SM, Grady J, Dorsey K, Desai NR, Lin Z, Normand ST. Development and Testing of Improved Models to Predict Payment Using Centers for Medicare & Medicaid Services Claims Data. JAMA Network Open 2019, 2: e198406. PMID: 31411709, PMCID: PMC6694388, DOI: 10.1001/jamanetworkopen.2019.8406.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHeart failurePopulation-based programsPOA codesSingle diagnostic codeDiagnostic codesComparative effectiveness research studyPublic reportingIndex admission diagnosisDays of hospitalizationClinical Modification codesService claims dataAcute care hospitalsMultiple care settingsPatient-level modelsAdmission diagnosisTotal hospitalizationsCare hospitalPrevious diagnosisNinth RevisionMyocardial infarctionCandidate variablesCare settingsClaims dataMAIN OUTCOMEComparative Effectiveness of New Approaches to Improve Mortality Risk Models From Medicare Claims Data
Krumholz HM, Coppi AC, Warner F, Triche EW, Li SX, Mahajan S, Li Y, Bernheim SM, Grady J, Dorsey K, Lin Z, Normand ST. Comparative Effectiveness of New Approaches to Improve Mortality Risk Models From Medicare Claims Data. JAMA Network Open 2019, 2: e197314. PMID: 31314120, PMCID: PMC6647547, DOI: 10.1001/jamanetworkopen.2019.7314.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionICD-9-CM codesMortality risk modelHeart failureHospital admissionC-statisticMAIN OUTCOMEMortality rateRisk-standardized mortality ratesHospital risk-standardized mortality ratesIndex admission diagnosisPatients 65 yearsDays of hospitalizationComparative effectiveness studiesClaims-based dataHospital-level performance measuresMedicare claims dataPatient-level modelsCMS modelRisk-adjustment modelsRisk modelHospital performance measuresAdmission diagnosisNinth RevisionMyocardial infarction
2018
Gender Differences in Patient‐Reported Outcomes Among Adults With Atherosclerotic Cardiovascular Disease
Okunrintemi V, Valero‐Elizondo J, Patrick B, Salami J, Tibuakuu M, Ahmad S, Ogunmoroti O, Mahajan S, Khan SU, Gulati M, Nasir K, Michos ED. Gender Differences in Patient‐Reported Outcomes Among Adults With Atherosclerotic Cardiovascular Disease. Journal Of The American Heart Association 2018, 7: e010498. PMID: 30561253, PMCID: PMC6405598, DOI: 10.1161/jaha.118.010498.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAtherosclerosisCross-Sectional StudiesFemaleHealth CommunicationHealth Knowledge, Attitudes, PracticeHealth Status DisparitiesHealthcare DisparitiesHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedPatient Reported Outcome MeasuresPatient SatisfactionPhysician-Patient RelationsPlatelet Aggregation InhibitorsQuality of LifeRetrospective StudiesRisk FactorsSex FactorsUnited StatesYoung AdultConceptsHealth-related qualityBackground Atherosclerotic cardiovascular diseaseLower health-related qualityAtherosclerotic cardiovascular diseasePatient experienceCardiovascular diseaseHealth outcomesPoor patient-provider communicationImportant public health implicationsSelf-reported patient experienceNinth Revision codesPatient-centered outcomesPatient-reported outcomesPatient-provider communicationThird of deathsPoor perceptionPoor patient experiencePositive patient experiencePublic health implicationsMedical Expenditure PanelPerception of healthGender-specific differencesRepresentative US sampleGender differencesASCVD patients