{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T10:00:18Z","timestamp":1791540018635,"version":"4.3.4"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Low\u2010density lipoprotein cholesterol (LDL\u2010C) control is higher among insured than uninsured adults, but data on time trends and contributing factors are incomplete and important for improving health equity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Awareness, treatment, and control of elevated LDL\u2010C were compared among insured versus uninsured and publicly versus privately insured adults, aged 21 to 64\u00a0years, in National Health and Nutrition Examination Surveys from 2001 to 2004, 2005 to 2008, and 2009 to 2012 using Adult Treatment Panel\u20103 criteria. Compared with insured adults, uninsured adults were younger; were more often minority; reported lower incomes, less education, and fewer healthcare encounters; and had lower awareness and treatment of elevated LDL\u2010C (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001). LDL\u2010C control was higher among insured than uninsured adults in 2001 to 2004 (mean\u00b1SEM, 21.4\u00b11.6% versus 10.5\u00b12.6%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01), and the gap widened by 2009 to 2012 (35.1\u00b11.9% versus 11.3\u00b12.2%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001). Despite more minorities (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01), greater poverty, and less education (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), publicly insured adults had more healthcare visits\/year than privately insured adults (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and similar awareness, treatment, and control of LDL\u2010C from 2001 to 2012. In multivariable logistic regression, significant positive predictors of cholesterol awareness, treatment, and control included more frequent health care (strongest), increasing age, private healthcare insurance versus uninsured, and hypertension. Public insurance (versus uninsured) was a significant positive predictor of LDL\u2010C control, whereas income &lt;200% versus \u2265200% of federal poverty was a significant negative predictor.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">LDL\u2010C control improved similarly over time in publicly and privately insured adults but was stagnant among the uninsured. Healthcare insurance largely addresses socioeconomic barriers to effective LDL\u2010C management, yet poverty retains an independent adverse effect.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.117.006105","type":"journal-article","created":{"date-parts":[[2017,11,3]],"date-time":"2017-11-03T00:10:59Z","timestamp":1509667859000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Cholesterol Control Among Uninsured Adults Did Not Improve From 2001\u20102004 to 2009\u20102012 as Disparities With Both Publicly and Privately Insured Adults Doubled"],"prefix":"10.1161","volume":"6","author":[{"given":"Brent M.","family":"Egan","sequence":"first","affiliation":[{"name":"Care Coordination Institute, Greenville, SC"},{"name":"Department of Medicine, University of South Carolina School of Medicine, Greenville, SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiexiang","family":"Li","sequence":"additional","affiliation":[{"name":"Care Coordination Institute, Greenville, SC"},{"name":"Department of Mathematics, College of Charleston, Charleston, SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara M.","family":"Sarasua","sequence":"additional","affiliation":[{"name":"Care Coordination Institute, Greenville, SC"},{"name":"Clemson University School of Nursing, Clemson, SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Davis","sequence":"additional","affiliation":[{"name":"Care Coordination Institute, Greenville, SC"},{"name":"Department of Medicine, University of South Carolina School of Medicine, Greenville, SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin A.","family":"Fiscella","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, University of Rochester Medical Center, Rochester, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan N.","family":"Tobin","sequence":"additional","affiliation":[{"name":"Clinical Directors Network, New York, NY"},{"name":"Center for Clinical and Translational Science, The Rockefeller University, New York, NY"},{"name":"Department of Epidemiology and Population Health, Albert Einstein College of Medicine\/Montefiore Medical Center, Bronx, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel W.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Medicine and Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Sinopoli","sequence":"additional","affiliation":[{"name":"Care Coordination Institute, Greenville, SC"},{"name":"Department of Medicine, University of South Carolina School of Medicine, Greenville, SC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.11.002"},{"key":"e_1_3_3_3_2","first-page":"1","article-title":"Statins for the primary prevention of cardiovascular disease","volume":"1","author":"Taylor F","year":"2013","unstructured":"Taylor F, Huffman MD, Macedo TH, Moore TH, Burke M, Davey Smith G, Ward K, Ebrahim S. 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