TY - JOUR
T1 - Contribution of contemporaneous risk factors to social inequality in coronary heart disease and all causes mortality
AU - Woodward, Mark
AU - Oliphant, Jane
AU - Lowe, Gordon
AU - Tunstall-Pedoe, Hugh
N1 - Funding Information:
The SHHS has been funded by the Chief Scientist Office of the Department of Health of the Scottish Executive and by the British Heart Foundation. Jane Oliphant was funded by the Department of Health in London.
PY - 2003/5/1
Y1 - 2003/5/1
N2 - Background. The relationship between low social status and premature mortality is well established, although the explanation for this link is unclear. This study explores the contribution to the social inequalities in coronary heart disease (CHD) and death of smoking status, cotinine, alcohol status, type A personality score, leisure activity, diabetes, systolic and diastolic blood pressure, body mass index, total and HDL cholesterol, triglycerides, fibrinogen, and vitamin C consumption. Methods. A random sample of 11,629 Scottish men and women, ages 40-59 years, was recruited in 1984-1987 and followed up for an average of 7.7 years for death and major coronary events. Social status was measured by housing tenure - renters being more socially deprived. Hazard ratios were computed from Cox models. Results. Adjusted for age, renters have 1.48 times the risk of CHD compared to owner-occupiers (95% CI: 1.21, 1.80) in men and 2.64 (1.89, 3.68) in women, and for all-cause mortality 1.55 (1.26, 1.90) and 2.12 (1.58, 2.84). The 14 risk factors explained 73% (men) and 77% (women) of the social differences in CHD. Equivalent figures for deaths were 51 and 64%. Conclusions. Fourteen contemporaneous risk factors, smoking being the most important, explain most of the social differential in CHD and death.
AB - Background. The relationship between low social status and premature mortality is well established, although the explanation for this link is unclear. This study explores the contribution to the social inequalities in coronary heart disease (CHD) and death of smoking status, cotinine, alcohol status, type A personality score, leisure activity, diabetes, systolic and diastolic blood pressure, body mass index, total and HDL cholesterol, triglycerides, fibrinogen, and vitamin C consumption. Methods. A random sample of 11,629 Scottish men and women, ages 40-59 years, was recruited in 1984-1987 and followed up for an average of 7.7 years for death and major coronary events. Social status was measured by housing tenure - renters being more socially deprived. Hazard ratios were computed from Cox models. Results. Adjusted for age, renters have 1.48 times the risk of CHD compared to owner-occupiers (95% CI: 1.21, 1.80) in men and 2.64 (1.89, 3.68) in women, and for all-cause mortality 1.55 (1.26, 1.90) and 2.12 (1.58, 2.84). The 14 risk factors explained 73% (men) and 77% (women) of the social differences in CHD. Equivalent figures for deaths were 51 and 64%. Conclusions. Fourteen contemporaneous risk factors, smoking being the most important, explain most of the social differential in CHD and death.
KW - Coronary disease
KW - Mortality
KW - Smoking
KW - Social class
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U2 - 10.1016/S0091-7435(03)00010-0
DO - 10.1016/S0091-7435(03)00010-0
M3 - Article
C2 - 12689801
AN - SCOPUS:0037402180
SN - 0091-7435
VL - 36
SP - 561
EP - 568
JO - Preventive Medicine
JF - Preventive Medicine
IS - 5
ER -