Racial/ethnic differences in the associations between social support and cardiovascular morbidity and mortality in the Multi-Ethnic Study of Atherosclerosis (MESA)

BMC Public Health. 2025 Jan 16;25(1):192. doi: 10.1186/s12889-024-21141-0.

Abstract

Background: Despite the established link between social support and cardiovascular disease (CVD) outcomes, few studies have examined racial/ethnic variation in these associations. This study utilized data from the Multi-Ethnic Study of Atherosclerosis (MESA) to investigate racial/ethnic differences in perceived social support and in the link between support and incident hard CVD events and mortality.

Method: Participants (N = 6,814) were 45-84 years of age who identified as White, Black, Hispanic/Latino, or Chinese without known clinical CVD at baseline (2000-2002). Racial/ethnic differences in perceived support (overall, emotional, informational, and instrumental) were tested using multiple regression with adjustments for demographic, socioeconomic, lifestyle/psychosocial, and clinical risk factors, and immigration history. Racial/ethnic differences in the association between perceived support and incident CVD events or mortality were tested using Cox proportional hazards models with progressive adjustments for the same covariates.

Results: At baseline, the mean age was 62.15 years (SD = 10.23); 38.5% identified as White, 27.8% as Black, 22.0% as Hispanic/Latino, and 11.8% as Chinese. Black and Hispanic/Latino participants reported higher levels of overall support, emotional support, and informational support than White participants (p's < 0.05). Chinese participants reported less informational support (p = .010) than White participants. Higher informational support was associated with decreased risk for hard CVD events. This association did not differ by race/ethnic group.

Conclusion: Despite racial/ethnic differences in perceptions of support, perceived informational support was protective against CVD for participants of all racial/ethnic backgrounds.

Keywords: Cardiovascular morbidity; Cardiovascular mortality; Culture; Ethnicity; Race; Social support.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Asian / statistics & numerical data
  • Atherosclerosis* / ethnology
  • Atherosclerosis* / mortality
  • Black or African American / psychology
  • Cardiovascular Diseases* / ethnology
  • Cardiovascular Diseases* / mortality
  • Ethnicity*
  • Female
  • Hispanic or Latino / psychology
  • Humans
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Social Support*
  • United States / epidemiology
  • White / psychology