Socioeconomic Inequalities in the Morbidity and Mortality of Acute Coronary Events in Finland: 1988 to 2002

Lammintausta, Aino; Immonen-Räihä, Pirjo; Airaksinen, Juhani; Torppa, Jorma; Harald, Kennet; Ketonen, Matti; Lehto, Seppo; Koukkunen, Heli; Kesäniemi, Antero; Kärjä-Koskenkari, Päivi; Salomaa, Veikko

doi:10.1016/j.annepidem.2011.10.012

Cited by 36 publications

(33 citation statements)

References 21 publications

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“…The exclusive use of effect measures in most of the studies -prevalence differences and ratios, or odds ratios- can omit a fundamental aspect: even if the strength of the relationship between socioeconomic status and health does not vary [21,22] or even decreases [12], inequalities may instead be growing because the weight of the population facing the risk factors (i.e. unemployment, poverty, etc.)…”

Section: Why Are These Results Observed? Reflections On the Effect Ofmentioning

confidence: 99%

“…Indeed, inequalities in long-standing illness and self-perceived health decreased [18,19], and mortality did not increase more than it was already doing before the crisis in Finland [20]. Additionally, other studies show that inequalities in cardiovascular mortality, disability and self-perceived health in Sweden and Finland remained stable during the crisis [21,22]. …”

Section: What Are the Consequences Of Crises On Health Inequalities?mentioning

confidence: 99%

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The impact of economic crises on social inequalities in health: what do we know so far?

Bacigalupe

Escolar-Pujolar²

2014

Int J Equity Health

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Since 2008, Western countries are going through a deep economic crisis whose health impacts seem to be fundamentally counter-cyclical: when economic conditions worsen, so does health, and mortality tends to rise. While a growing number of studies have presented evidence on the effect of crises on the average population health, a largely neglected aspect of research is the impact of crises and the related political responses on social inequalities in health, even if the negative consequences of the crises are primarily borne by the most disadvantaged populations. This commentary will reflect on the results of the studies that have analyzed the effect of economic crises on social inequalities in health up to 2013. With some exceptions, the studies show an increase in health inequalities during crises, especially during the Southeast Asian and Japanese crises and the Soviet Union crisis, although it is not always evident for both sexes or all health or socioeconomic variables. In the Nordic countries during the nineties, a clear worsening of health equity did not occur. Results about the impacts of the current economic recession on health equity are still inconsistent. Some of the factors that could explain this variability in results are the role of welfare state policies, the diversity of time periods used in the analyses, the heterogeneity of socioeconomic and health variables considered, the changes in the socioeconomic profile of the groups under comparison in times of crises, and the type of measures used to analyze the magnitude of social inequalities in health. Social epidemiology should further collaborate with other disciplines to help produce more accurate and useful evidence about the relationship between crises and health equity.

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Section: Why Are These Results Observed? Reflections On the Effect Ofmentioning

confidence: 99%

Section: What Are the Consequences Of Crises On Health Inequalities?mentioning

confidence: 99%

The impact of economic crises on social inequalities in health: what do we know so far?

Bacigalupe

Escolar-Pujolar²

2014

Int J Equity Health

View full text Add to dashboard Cite

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“…CHD mortality rates have declined substantially over the last decades,[5] partly because of improved survival after acute myocardial infarction (AMI) [6]–[8]. In addition, previous studies have reported different survival rates according to educational levels and it is not clear whether the improvement in survival has occurred in all educational levels [9]–[11]. Thus, true inequalities in the burden of disease may be better reflected using AMI incidence instead of mortality as the outcome.…”

Section: Introductionmentioning

confidence: 99%

“…Although educational inequalities in AMI incidence have been investigated,[11]–[15] most studies are either case-control studies[14] or small or medium-sized cohort-studies[16]–[18] with varying participation rates. We were able to identify six studies[11], [15], [19]–[22] on AMI incidence and educational level which covered the total population in a geographical area.…”

Section: Introductionmentioning

confidence: 99%

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Educational Inequalities in Acute Myocardial Infarction Incidence in Norway: A Nationwide Cohort Study

et al. 2014

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BackgroundIncreasing differences in cardiovascular disease (CVD) mortality across levels of education have been reported in Norway. The aim of the study was to investigate educational inequalities in acute myocardial infarction (AMI) incidence and whether such inequalities have changed during the past decade using a nationwide longitudinal study design.MethodsData on 141 332 incident (first) AMIs in Norway during 2001–2009 were obtained through the Cardiovascular Disease in Norway (CVDNOR) project. Educational inequalities in AMI incidence were assessed in terms of age-standardised incidence rates stratified on educational level, incidence rate ratios (IRR), relative index of inequality (RII) and slope index of inequality (SII). All calculations were conducted in four gender and age strata: Men and women aged 35–69 and 70–94 years.ResultsAMI Incidence rates decreased during 2001–2009 for all educational levels except in women aged 35–69 among whom only those with basic education had a significant decrease. In all gender and age groups; those with the highest educational level had the lowest rates. The strongest relative difference was found among women aged 35–69, with IRR (95% CI) for basic versus tertiary education 3.04 (2.85–3.24)) and RII (95% CI) equal to 4.36 (4.03–4.71). The relative differences did not change during 2001–2009 in any of the four gender and age groups, but absolute inequalities measured as SII decreased among the oldest men and women.ConclusionsThere are substantial educational inequalities in AMI incidence in Norway, especially for women aged 35–69. Relative inequalities did not change from 2001 to 2009.

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Does working long hours increase the risk of cardiovascular disease for everyone?

Lee

Kim

Myong

et al. 2019

Journal of Occupational Health

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Introduction It has been suggested that long working hours are associated with cardiovascular disease (CVD). Although studies on health inequality caused by income inequality have been performed, income levels of workers have been considered only as an adjusting factor in the relationship between long working hours and CVD. In the present study, we investigated the modifying effects of household income level in the relationship between working hours and estimated risk of CVD. Materials and Methods We analysed a total of 11,602 Koreans who were randomly enrolled in the Korea National Health and Nutrition Examination Survey (2007‐2016) with complete data. Nonparametric associations between weekly working hours and estimated risk of CVD were explored according to quartiles of equalised household income by gender, and the size of linear associations among weekly working hours and estimated CVD risk after stratifying for equalised household income by gender was considered. Results A 4.1% increased risk of CVD was associated with 10 hours or longer per day weekly working hours among males with the highest household income after adjusting for age, equalised household income, occupation, and shift work, but such was not associated among lower income groups. Negative associations between equalised household income and estimated CVD risk were observed only among low household income males. Conclusion Long working hours and household income level can have differential effects on the risk of CVD by socioeconomic status. This study shows that positive income effect may dominate the potential negative effect of long working hours with respect to the risk of CVD in the low‐income group.

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Socioeconomic Inequalities in the Morbidity and Mortality of Acute Coronary Events in Finland: 1988 to 2002

Cited by 36 publications

References 21 publications

The impact of economic crises on social inequalities in health: what do we know so far?

The impact of economic crises on social inequalities in health: what do we know so far?

Educational Inequalities in Acute Myocardial Infarction Incidence in Norway: A Nationwide Cohort Study

Does working long hours increase the risk of cardiovascular disease for everyone?

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