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Trends in social inequalities for premature coronary heart disease mortality in Great Britain, 1994-2008: a time trend ecological study.

McCartney D, Scarborough P, Webster P, Rayner M - BMJ Open (2012)

Bottom Line: None.There has been a decrease in socioeconomic inequalities in CHD mortality in absolute terms but an increase in relative terms.In the context of falling CHD mortality rates, narrowing of absolute inequalities is to be expected, but increases in relative inequalities are a cause for concern.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health, University of Oxford, Oxford, UK.

ABSTRACT

Objective: To compare trends in metrics of socioeconomic inequalities in premature coronary heart disease (CHD) mortality in Great Britain.

Design: Time trend ecological study with area-level deprivation as exposure.

Setting: Great Britain, 1994-2008.

Participants: Men and women aged younger than 75 years. No lower age limit.

Interventions: None.

Main outcome measures: CHD mortality rates.

Results: There has been a decrease in socioeconomic inequalities in CHD mortality in absolute terms but an increase in relative terms. CHD mortality rates in men aged younger than 75 years fell by 69 per 100 000 (95% CIs 64 to 74) in the least deprived quintile and by 92 per 100 000 (95% CI 86 to 98) in the most deprived quintile (p for trend: <0.001). Mortality rate ratios comparing the most deprived quintile to the least deprived quintile increased in women aged younger than 75 years from 1.77 (95% CI 1.68 to 1.86) to 2.32 (95% CI 2.14 to 2.52). There was a weak negative association between the average decline of relative rates and area deprivation.

Conclusions: It could either be said that inequalities in premature mortality from CHD between affluent and deprived areas have widened or narrowed between 1994 and 2008 depending on the measurement technique. In the context of falling CHD mortality rates, narrowing of absolute inequalities is to be expected, but increases in relative inequalities are a cause for concern.

No MeSH data available.


Related in: MedlinePlus

Age-standardised coronary heart disease mortality rates per 100 000 for the period 1994 to 2008, by quintile of deprivation, Great Britain—women younger than 75 years.
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fig1: Age-standardised coronary heart disease mortality rates per 100 000 for the period 1994 to 2008, by quintile of deprivation, Great Britain—women younger than 75 years.

Mentions: Mortality rates for CHD declined steadily between 1994 and 2008 for areas at all levels of deprivation. Figure 1 shows the decline in CHD mortality rates for women younger than 75 years since 1994, by quintile of deprivation. Mortality rates in the more deprived groups have seen a greater absolute fall than more affluent areas. This has resulted in a narrowing of inequalities in absolute mortality rates over the time period. This pattern was the same for men younger than 75 years. Table 1 shows that the most deprived quintile had a significantly greater decline in CHD mortality rates than the least deprived quintile, for both men and women. For men, mortality rates fell by 69 (95% CI 64 to 74) per 100 000 in the most affluent quintile compared with 92 (95% CI 86 to 98) per 100 000 in the least affluent quintile.


Trends in social inequalities for premature coronary heart disease mortality in Great Britain, 1994-2008: a time trend ecological study.

McCartney D, Scarborough P, Webster P, Rayner M - BMJ Open (2012)

Age-standardised coronary heart disease mortality rates per 100 000 for the period 1994 to 2008, by quintile of deprivation, Great Britain—women younger than 75 years.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3378944&req=5

fig1: Age-standardised coronary heart disease mortality rates per 100 000 for the period 1994 to 2008, by quintile of deprivation, Great Britain—women younger than 75 years.
Mentions: Mortality rates for CHD declined steadily between 1994 and 2008 for areas at all levels of deprivation. Figure 1 shows the decline in CHD mortality rates for women younger than 75 years since 1994, by quintile of deprivation. Mortality rates in the more deprived groups have seen a greater absolute fall than more affluent areas. This has resulted in a narrowing of inequalities in absolute mortality rates over the time period. This pattern was the same for men younger than 75 years. Table 1 shows that the most deprived quintile had a significantly greater decline in CHD mortality rates than the least deprived quintile, for both men and women. For men, mortality rates fell by 69 (95% CI 64 to 74) per 100 000 in the most affluent quintile compared with 92 (95% CI 86 to 98) per 100 000 in the least affluent quintile.

Bottom Line: None.There has been a decrease in socioeconomic inequalities in CHD mortality in absolute terms but an increase in relative terms.In the context of falling CHD mortality rates, narrowing of absolute inequalities is to be expected, but increases in relative inequalities are a cause for concern.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health, University of Oxford, Oxford, UK.

ABSTRACT

Objective: To compare trends in metrics of socioeconomic inequalities in premature coronary heart disease (CHD) mortality in Great Britain.

Design: Time trend ecological study with area-level deprivation as exposure.

Setting: Great Britain, 1994-2008.

Participants: Men and women aged younger than 75 years. No lower age limit.

Interventions: None.

Main outcome measures: CHD mortality rates.

Results: There has been a decrease in socioeconomic inequalities in CHD mortality in absolute terms but an increase in relative terms. CHD mortality rates in men aged younger than 75 years fell by 69 per 100 000 (95% CIs 64 to 74) in the least deprived quintile and by 92 per 100 000 (95% CI 86 to 98) in the most deprived quintile (p for trend: <0.001). Mortality rate ratios comparing the most deprived quintile to the least deprived quintile increased in women aged younger than 75 years from 1.77 (95% CI 1.68 to 1.86) to 2.32 (95% CI 2.14 to 2.52). There was a weak negative association between the average decline of relative rates and area deprivation.

Conclusions: It could either be said that inequalities in premature mortality from CHD between affluent and deprived areas have widened or narrowed between 1994 and 2008 depending on the measurement technique. In the context of falling CHD mortality rates, narrowing of absolute inequalities is to be expected, but increases in relative inequalities are a cause for concern.

No MeSH data available.


Related in: MedlinePlus