Article

Socioeconomic Indicators and the Risk of Acute Coronary Heart Disease Events: Comparison of Population-Based Data from the United States and Finland

University of North Carolina at Chapel Hill, USA.
Annals of epidemiology (Impact Factor: 2). 08/2011; 21(8):572-9. DOI: 10.1016/j.annepidem.2011.04.006
Source: PubMed

ABSTRACT

We wished to determine whether a gradient of association of low socioeconomic status with incidence of coronary heart disease was present in two population-based cohorts, one from United States and the other from Finland.
Using data from the Atherosclerosis Risk in Communities (ARIC) cohort and the Finnish FINRISK cohort, we estimated, with Cox proportional hazard regression models, incidence of sudden cardiac death (SCD), non-sudden cardiac death (NSCD), and non-fatal myocardial infarction (NFMI) for strata of income and education (follow-up: 1987-2001). In both cohorts, incidence rates of the three outcomes increased across all socioeconomic status exposure categories.
Low education was associated with increased hazard of NFMI in both cohorts and with increased risk of SCD among ARIC women. Low income was significantly associated with increased hazard of all three outcomes among ARIC women and with increased hazard of cardiac death among ARIC men. In FINRISK, low income was significantly associated with increased risk of SCD only. Risk of SCD in the low income categories was similar for both cohorts. Smoking, alcohol consumption, and race (ARIC only) did not appreciably alter effect estimates in either cohort.
Indices of low SES show similar associations with increased risk of cardiac events in Finland and in United States.

Full-text preview

Available from: ncbi.nlm.nih.gov
    • "Previous studies have shown that low socioeconomic status of individuals is linked with higher incidences of acute coronary diseases, increased sudden cardiac deaths and higher mortality rates after the first myocardial infarctions.[78] When compared to the individuals in a higher socioeconomic status, this increased risk for cardiovascular events in the lower socioeconomic individuals is not due to the differences in smoking, alcohol consumption or race, but is rather secondary to the lower education levels, less knowledge of cardiovascular diseases and limited access to healthcare resources.[79] "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background:Psychosocial stress is one important risk factor for myocardial infarction.Aim:The study was to assess the impact of the 2008-2009 economic recession on myocardial infarction occurrences in different socioeconomic areas of Raritan Bay region, New Jersey.Materials and Methods:The patients, who were treated for acute myocardial infarction from January 2006 to June 2012, were grouped based on the average incomes of their residence districts in the Raritan Bay region. The Spearman Rank Correlation test was used to assess the correlation between the monthly occurrences of myocardial infarction and Dow Jones stock averages, as well as the correlation between the myocardial infarction occurrences and NJ State unemployment rates.Results:Among 1,491 cases that were identified, 990 cases resided in areas with income below the state average and 477 were from areas above the average. After the onset of the recession, the myocardial infarction occurrences trended up in the low-income area group but not in the high-income area group; and this increasing trend is correlated with the rise in NJ State unemployment rates but not with the changes in stock averages.Conclusion:Our findings suggest that unemployment contributed to an increased risk of myocardial infarction among the residents in low socioeconomic areas after the 2008-2009 economic recession.
    No preview · Article · May 2014 · North American Journal of Medical Sciences
  • [Show abstract] [Hide abstract]
    ABSTRACT: The leading question of this paper is whether it makes any sense, is credible or feasible to adopt aims of sensibleness and rationalization in the health care system (so strictly connected to the social and economical sector) while the criteria used by the social, economical and cultural contexts (nationally and internationally) are based on the denial of evidences, on misinterpretation of data. Some arbitrary and difficult to justify decisions are glossed over with labels of rigour and planning. Four scenarios (the role of the evidences; the global health, the mental health and the role of citizens-leading or passive role) allow to propose some provocative reflections, backed up by the most recent articles published on the most important international medical journals.
    No preview · Article · Jul 2011 · Assistenza infermieristica e ricerca: AIR
  • Source

    Full-text · Article · Aug 2011 · Annals of epidemiology
Show more