Prospective associations between US state-level corruption and individual-level cardiovascular risk factors among middle
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ORIGINAL ARTICLE
Prospective associations between US state-level corruption and individual-level cardiovascular risk factors among middle-aged Americans: The National Longitudinal Survey of Youths 1979 Krisztina Gero1
•
Daniel Kim1
Received: 4 February 2020 / Revised: 8 July 2020 / Accepted: 22 September 2020 Swiss School of Public Health (SSPH+) 2020
Abstract Objectives To estimate the associations between US state-level corruption and risk factors for cardiovascular disease, one of the leading causes of mortality and morbidity in the nation. Methods We used a US nationally-representative sample of middle-aged adults from the National Longitudinal Survey of Youths 1979 and data from the Corruption in America Survey to estimate the associations between state-level illegal (private gains) corruption and legal (political gains) corruption in 2013 and individual-level risks of incident diabetes, hypertension, obesity, and depression between 2014 and 2016. Results Medium and higher levels of illegal corruption were associated with odds ratios (ORs) of 1.75 (95% CI 1.06–2.88) for incident diabetes and 1.70 (95% CI 1.15–2.51) for incident hypertension, respectively. Furthermore, a higher level of legal corruption was associated with ORs of 1.84 (95% CI 1.08–3.13) for diabetes and 1.58 (95% CI 1.05–2.38) for hypertension. No consistent associations were observed for obesity or depression. Conclusions Our findings suggest that higher levels of corruption contribute to increased risks of developing diabetes and hypertension. Investing resources into fighting corruption may be means to reduce the national burden of cardiovascular disease. Keywords Corruption Cardiovascular risk factors Diabetes Obesity Social determinants of health National Longitudinal Survey of Youths 1979 Corruption in America Survey
Introduction Government corruption is a widespread issue that affects developed and developing countries alike, including the United States (US). Defined as the abuse of entrusted power for personal benefit, corruption has far-reaching consequences, affecting political, economic, as well as social and environmental domains (International 2018; Li et al. 2018). Whether it is for private or political gain, corruption can effectively steer decision-makers,
& Daniel Kim [email protected] Krisztina Gero [email protected] 1
Department of Health Sciences, Bouve´ College of Health Sciences, Northeastern University, Boston, MA, USA
potentially influencing policymaking and jeopardizing the legitimacy of legal institutions. Affected redistribution policies might lead to increasing income inequality, while the inappropriate handling of public resources contributes to decreasing investment in the healthcare system (Apergis et al. 2010; Witvliet et al. 2013; Factor and Kang 2015; Lio and Lee 2016; Li et al. 2018). Apart from its adverse effects on healthcare policies, a growing body of evidence shows that corruption can also influence health as a contextual socia
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