Low socioeconomic status of a patient's residential area is associated with worse prognosis after acute myocardial infarction in Sweden

Bergström, Göran; Redfors, Björn; Angerås, Oskar; Dworeck, Christian; Shao, Yangzhen; Haraldsson, Inger; Pétursson, Pétur; Miličić, Davor; Wedel, Hans; Albertsson, Per; Råmunddal, Truls; Rosengren, Annika; Ömerovic, Elmir

doi:10.1016/j.ijcard.2014.12.060

Cited by 39 publications

(16 citation statements)

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“…For example, findings from multiple studies have shown that individuals of lower socioeconomic status have increased rates of cardiovascular and circulatory diseases. 39-47 …”

Section: Discussionmentioning

confidence: 99%

Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: quantifying the epidemiological transition

Murray¹,

Barber²,

Foreman³

et al. 2015

The Lancet

1,665

1,034

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Summary Background The Global Burden of Disease Study 2013 (GBD 2013) aims to bring together all available epidemiological data using a coherent measurement framework, standardised estimation methods, and transparent data sources to enable comparisons of health loss over time and across causes, age–sex groups, and countries. The GBD can be used to generate summary measures such as disability-adjusted life-years (DALYs) and healthy life expectancy (HALE) that make possible comparative assessments of broad epidemiological patterns across countries and time. These summary measures can also be used to quantify the component of variation in epidemiology that is related to sociodemographic development. Methods We used the published GBD 2013 data for age-specific mortality, years of life lost due to premature mortality (YLLs), and years lived with disability (YLDs) to calculate DALYs and HALE for 1990, 1995, 2000, 2005, 2010, and 2013 for 188 countries. We calculated HALE using the Sullivan method; 95% uncertainty intervals (UIs) represent uncertainty in age-specific death rates and YLDs per person for each country, age, sex, and year. We estimated DALYs for 306 causes for each country as the sum of YLLs and YLDs; 95% UIs represent uncertainty in YLL and YLD rates. We quantified patterns of the epidemiological transition with a composite indicator of sociodemographic status, which we constructed from income per person, average years of schooling after age 15 years, and the total fertility rate and mean age of the population. We applied hierarchical regression to DALY rates by cause across countries to decompose variance related to the sociodemographic status variable, country, and time. Findings Worldwide, from 1990 to 2013, life expectancy at birth rose by 6·2 years (95% UI 5·6–6·6), from 65·3 years (65·0–65·6) in 1990 to 71·5 years (71·0–71·9) in 2013, HALE at birth rose by 5·4 years (4·9–5·8), from 56·9 years (54·5–59·1) to 62·3 years (59·7–64·8), total DALYs fell by 3·6% (0·3–7·4), and age-standardised DALY rates per 100 000 people fell by 26·7% (24·6–29·1). For communicable, maternal, neonatal, and nutritional disorders, global DALY numbers, crude rates, and age-standardised rates have all declined between 1990 and 2013, whereas for non–communicable diseases, global DALYs have been increasing, DALY rates have remained nearly constant, and age-standardised DALY rates declined during the same period. From 2005 to 2013, the number of DALYs increased for most specific non-communicable diseases, including cardiovascular diseases and neoplasms, in addition to dengue, food-borne trematodes, and leishmaniasis; DALYs decreased for nearly all other causes. By 2013, the five leading causes of DALYs were ischaemic heart disease, lower respiratory infections, cerebrovascular disease, low back and neck pain, and road injuries. Sociodemographic status explained more than 50% of the variance between countries and over time for diarrhoea, lower respiratory infections, and other common infectious diseases; maternal disorders; ...

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“…For example, findings from multiple studies have shown that individuals of lower socioeconomic status have increased rates of cardiovascular and circulatory diseases. 39-47 …”

Section: Discussionmentioning

confidence: 99%

Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: quantifying the epidemiological transition

Murray¹,

Barber²,

Foreman³

et al. 2015

The Lancet

1,665

1,034

View full text Add to dashboard Cite

show abstract

“…Previous studies have found that the prevalence of dietary habits 9 , 10 , cardiometabolic risk factors, and cardiovascular events 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 vary across sociodemographic groups and by the country's Human Development Index. For example, in high-income countries, there is a negative association between obesity and higher income and educational attainment, whereas in low-income countries, there is a positive association between education and obesity 17 , 21 .…”

mentioning

confidence: 97%

The Relationship Between Socioeconomic Status and CV Risk Factors: The CRONICAS Cohort Study of Peruvian Adults

Quispe

Benziger

Bazo‐Alvarez

et al. 2016

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BackgroundVariations in the distribution of cardiovascular disease and risk factors by socioeconomic status (SES) have been described in affluent societies, yet a better understanding of these patterns is needed for most low- and middle-income countries.ObjectiveThis study sought to describe the relationship between cardiovascular risk factors and SES using monthly family income, educational attainment, and assets index, in 4 Peruvian sites.MethodsBaseline data from an age- and sex-stratified random sample of participants, ages ≥35 years, from 4 Peruvian sites (CRONICAS Cohort Study, 2010) were used. The SES indicators considered were monthly family income (n = 3,220), educational attainment (n = 3,598), and assets index (n = 3,601). Behavioral risk factors included current tobacco use, alcohol drinking, physical activity, daily intake of fruits and vegetables, and no control of salt intake. Cardiometabolic risk factors included obesity, elevated waist circumference, hypertension, insulin resistance, diabetes mellitus, low high-density lipoprotein cholesterol, and high triglyceride levels.ResultsIn the overall population, 41.6% reported a monthly family income

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“…39 Increased investment in catheter laboratories located in health boards with high levels of deprivation may also have had some effect on reducing socioeconomic inequity, along with falling thresholds in eligibility for revascularisation, since SES is associated with worse clinical prognosis after AMI. 40 However, in contrast, women and older patients continued to be significantly less likely to receive revascularisation in the 6 months following AMI admission. The most likely explanation for inequity associated with age is the presence of comorbidities, and it is possible that our models could not adequately capture this real-world factor.…”

Section: Possible Explanations and Implications Of Study Resultsmentioning

confidence: 96%

Impact of service redesign on the socioeconomic inequity in revascularisation rates for patients with acute myocardial infarction: a natural experiment and electronic record-linked cohort study

et al. 2016

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AimTo investigate the impact of service redesign in the provision of revascularisation procedures on the historical socioeconomic inequity in revascularisation rates for patients with acute myocardial infarction (AMI).DesignNatural experiment and retrospective cohort study using linked data sets in the Secure Anonymised Information Linkage databank.Non-randomised interventionAn increase in the capacity of revascularisation procedures and service redesign in the provision of revascularisation in late 2011 to early 2012.SettingSouth Wales cardiac network, Census 2011 population 1 359 051 aged 35 years and over.Participants9128 participants admitted to an NHS hospital with a first AMI between 1 January 2010 and 30 June 2013, with 6-months follow-up.Main outcome measureHazard ratios (HRs) for the time to revascularisation for deprivation quintiles, age, gender, comorbidities, rural–urban classification and revascularisation facilities of admitting hospital.ResultsIn the preintervention period, there was a statistically significant decreased adjusted risk of revascularisation for participants in the most deprived quintile compared to the least deprived quintile (HR 0.80; 95% CI 0.69 to 0.92, p=0.002). In the postintervention period, the increase in revascularisation rates was statistically significant in all quintiles, and there was no longer any statistically significant difference in the adjusted revascularisation risk between the most and the least deprived quintile (HR 1.04; 95% CI 0.89 to 1.20, p<0.649). However, inequity persisted for those aged 75 years and over (HR 0.40; 95% CI 0.35 to 0.46, p<0.001) and women (HR 0.77; 95% CI 0.70 to 0.86, p<0.001).ConclusionsSocioeconomic inequity of access to revascularisation was no longer apparent following redesign of revascularisation services in the south Wales cardiac network, although inequity persisted for women and those aged 75+ years. Increasing the capacity of revascularisation did not differentially benefit participants from the least deprived areas.

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Low socioeconomic status of a patient's residential area is associated with worse prognosis after acute myocardial infarction in Sweden

Cited by 39 publications

References 30 publications

Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: quantifying the epidemiological transition

Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: quantifying the epidemiological transition

The Relationship Between Socioeconomic Status and CV Risk Factors: The CRONICAS Cohort Study of Peruvian Adults

Impact of service redesign on the socioeconomic inequity in revascularisation rates for patients with acute myocardial infarction: a natural experiment and electronic record-linked cohort study

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