Neighbourhood socioeconomic status and coronary heart disease in individuals between 40 and 50 years

Abstract

Objective The incidence of myocardial infarction (MI) has decreased in general but not among younger middle-aged adults. We performed a cohort study of the association between neighbourhood socioeconomic status (SES) at the age of 40 and risk of MI before the age of 50 years. Methods All individuals in Sweden were included in the year of their 40th birthday, if it occurred between 1998 and 2010. National registers were used to categorise neighbourhood SES into high, middle and low, and to retrieve information on incident MI and coronary heart disease (CHD). Cox regression models, adjusted for marital status, education level, immigrant status and region of residence, provided an estimate of the HRs and 95% CIs for MI or CHD. Results Out of 587 933 men and 563 719 women, incident MI occurred in 2877 (0.48%) men and 932 (0.17%) women; and CHD occurred in 4400 (0.74%) men and 1756 (0.31%) women during a mean follow-up of 5.5 years. Using individuals living in middle-SES neighbourhoods as referents, living in high-SES neighbourhoods was associated with lower risk of MI in both sexes (HR (95% CI): men: 0.72 (0.64 to 0.82), women: 0.66 (0.53 to 0.81)); living in low-SES neighbourhoods was associated with a higher risk of MI (HR (95% CI): men: 1.31 (1.20 to 1.44), women: 1.28 (1.08 to 1.50)). Similar risk estimates for CHD were found. Conclusions The results of our study suggest an increased risk of MI and CHD among residents from low-SES neighbourhoods and a lower risk in those from high-SES neighbourhoods compared with residents in middle-SES neighbourhoods.

Neighborhoods and mortality in Sweden: Is deprivation best assessed nationally or regionally?

“…For example, associations between neighborhood deprivation and mortality due to all causes and cardiovascular mortality in addition to cardiovascular morbidity and poor overall health have been reported (Chaix 2009;Cummins et al 2007;Diez-Roux et al 1997;Diez-Roux 2001;Diez-Roux et al 2001;Diez-Roux et al 2016;Meijer et al 2012;Pickett and Pearl 2001). Several studies conducted in Sweden have reported similar findings: For example, coronary heart disease (CHD) incidence rates as well as case fatalities were higher in deprived neighborhoods than in wealthier neighborhoods (Winkleby, Sundquist, and Cubbin 2007;Chaix, Rosvall, and Merlo 2007;Carlsson et al 2016;Oudin Åström, Sundquist and Sundquist 2018). Another Swedish study reported that individuals with diabetes residing in deprived neighborhoods had higher odds of being hospitalized for CHD than those who resided in wealthy neighborhoods (Chaikiat et al 2012).…”

Association of socioeconomic status with outcomes in older adult community-dwelling patients after visiting the emergency department: a retrospective cohort study

“…First, our results are not generalisable to cardiology and gynaecology patients as we excluded these patients. For these cardiology patients, it is known that low SES may have a stronger association with adverse outcomes, 42 and excluding these from our study may explain that we did not find associations between SES and outcome (except for hospitalisation in community dwelling patients). Second, we retrieved SES on the basis of zip codes, which may be imprecise and yield smaller associations of SES with adverse outcomes.…”

The usefulness of small-area-based socioeconomic characteristics in assessing the treatment outcomes of type 2 diabetes patients: a register-based mixed-effect study

“…Individual-level and area-based socioeconomic status (SES), such as income, education and occupation, have been used to examine the associations between SES and health risks in chronic disease patients. For example, previous research has shown that low individual or neighbourhood SES is associated with the risk of getting diabetes [ 1 – 3 ], the increased prevalence of chronic obstructive airway diseases [ 4 ], all-cause mortality in adults with atrial fibrillation [ 5 ] and increased risk of coronary heart disease [ 6 – 8 ]. In addition, the care of diabetes can be influenced by individual and neighbourhood SES [ 9 , 10 ].…”