Int. J. Environ. Res. Public Health 2011, 8 2. Experimental Section 2.1. Methods 2508 Baseline interview data collected from 5301 African Americans, living in the tri-county area of metropolitan Jackson, Mississippi; Hinds, Madison and Rankin counties and participating in the Jackson Heart Study, were analyzed. The Jackson Heart Study (JHS) is the largest single-site epidemiological study of cardiovascular disease on African-Americans on record. A systematic review of the JHS data was made focusing on medication use, CVD health status, and demographic parameters to examine practices and behaviors of the participants and association between those practices and the primary health outcome, hospitalization. Details of the JHS, its development, participants, and overall procedures are described further by Addison et al. [24] and Campbell-Jenkins et al. [25] in earlier publications. Demographic variables of the JHS participants (age, education level, age, income, and county of residence) were extracted from the Household Enumeration Form (HEF) and Personal Data— Socioeconomic Status Form (PDS). Cardiovascular conditions of JHS participants at baseline (high blood pressure, high cholesterol, heart attack, diabetes, and stroke) were obtained from the Personal and Family History Form (PFHA). On this form, participants responded with a “yes”, “no”, or “don’t know” answer about whether they were told by a physician that they had certain diseases. JHS participants’ CVD medication use was obtained from the Medication Survey Form (MSRA). On this form, the participants were again asked to respond with a “with a “yes”, “no”, or “don’t know” answer about whether they had taken medication for high blood pressure, high cholesterol, heart attack, diabetes, or stroke during the two weeks prior to coming to the Exam Center for their clinic exams. Self-report of adherence to medications is a useful and expedient way of assessing adherence [26]. JHS participants’ reasons for not taking the doctor-prescribed medication were also elicited from the MSRA. Participants were given a list of potential reasons cited that prevented people from taking medication as prescribed, and asked to indicate with a “yes”, “no”, or “don’t know” answer. The primary study outcome was self-reported hospitalization for CVD which was extracted from the participants’ annual follow-up interviews. Subjects were asked at 1-year follow-up interviews whether they had been hospitalized for CVD during the previous 12 months. 2.2. Statistical Analysis We calculated CVD health status among participants by age, gender, education, and income. We ascertained adherence to medication among participants with self-reported CVD-related morbidity by age, gender, education, and income. Differences in the occurrence of hospitalizations between participants who adhere to a medical regimen and those who do not were assessed. Because medication non-adherence may act on the causal pathway between a risk factor and subsequent hospitalization for CVD, this study evaluated medication adherence as a risk factor for CVD-related hospitalization, taking baseline CVD conditions into account. We analyzed the binary outcome of hospitalization or no- hospitalization for CVD-related health status using logistic regression analysis, with separate models for each predictor variable to assess the association between the medication adherence of diagnosed