Psychosocial and Cultural Influences on Cardiovascular Health and Quality of Life Among Hispanic Cardiac Patients

This study examined whether psychosocial and cultural factors were related to four dimen-sions of cardiac-related quality of life (global, physical, emotional, and social functioning) in 120 Hispanic coronary heart disease (CHD) outpatients in south Florida. Survey data were collected on sociodemographic (age, gender, socioeconomic status), psychosocial (depres-sion, social support), and cultural factors (acculturation, familism, fatalism), and quality of life. Medical data on CHD severity (New York Heart Association class, time since diagnosis) were obtained from patients ’ clinic records. Hierarchical regression analyses revealed that women and patients with more severe CHD had poorer quality of life than men or patients with less severe CHD. Psychosocial and cultural factors were associated with poorer quality of life after controlling for sociodemographic and medical variables: Depression was associ-ated with all four quality of life dimensions (p <.001); and fatalism (p <.05) was associated with lower social functioning in women. These findings identify Hispanic subgroups with poor cardiac-related quality of life that can benefit from special outreach. KEY WORDS: heart disease; hispanics; quality of life; depression; acculturation. Despite encouraging declines in heart disease mortality rates, more people in the United States die from coronary heart disease (CHD) each year than from any other cause, accounting for 20 % of all adult deaths, and costing the U.S. economy over $111 billion per year (American Heart Association, 2002). CHD is also the leading cause of death among His-panics residing in the United States, regardless of gender or country of origin (American Heart Asso