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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

Relative coronary heart disease mortality rates (1994=100%) for the period 1994 to 2008, by quintile of deprivation, Great Britain—men younger than 75 years.
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fig2: Relative coronary heart disease mortality rates (1994=100%) for the period 1994 to 2008, by quintile of deprivation, Great Britain—men younger than 75 years.

Mentions: Figure 2 shows the relative decline in CHD mortality rates for men younger than 75 years by quintile of deprivation. The relative decline in the most deprived quintile between 1994 and 2008 was less than the relative decline in the least deprived quintile, and there was a clear gradient in decline within deprivation quintiles. At no point between 1994 and 2008 was the relative decline in the most deprived quintile greater than that in the least deprived quintile. For women, mortality rates in the most affluent quintile declined by 66% (62% to 69%) compared with 57% (95% CI 54% to 60%) for the least affluent quintile (see table 1).


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)

Relative coronary heart disease mortality rates (1994=100%) for the period 1994 to 2008, by quintile of deprivation, Great Britain—men 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

fig2: Relative coronary heart disease mortality rates (1994=100%) for the period 1994 to 2008, by quintile of deprivation, Great Britain—men younger than 75 years.
Mentions: Figure 2 shows the relative decline in CHD mortality rates for men younger than 75 years by quintile of deprivation. The relative decline in the most deprived quintile between 1994 and 2008 was less than the relative decline in the least deprived quintile, and there was a clear gradient in decline within deprivation quintiles. At no point between 1994 and 2008 was the relative decline in the most deprived quintile greater than that in the least deprived quintile. For women, mortality rates in the most affluent quintile declined by 66% (62% to 69%) compared with 57% (95% CI 54% to 60%) for the least affluent quintile (see table 1).

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