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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

Association between average annual percentage decline in coronary heart disease (CHD) mortality rates between 1994 and 2008 and deprivation, Great Britain—men younger than 75 years.
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fig4: Association between average annual percentage decline in coronary heart disease (CHD) mortality rates between 1994 and 2008 and deprivation, Great Britain—men younger than 75 years.

Mentions: Figure 4 shows the association between average annual decline in men younger than 75 years CHD mortality rates and deprivation for all local authorities in Great Britain. The variables demonstrate a weak association (r2=0.06, p<0.001). The association suggests that more deprived areas have a slower rate of decline in relative CHD mortality rates than more affluent areas. However, the weak association suggests that the level of deprivation of the local authority alone does little to describe the variance in decline in CHD mortality rates. This is the case for both men and women younger than 75 years CHD mortality rates and is demonstrated in table 1, where the IQR of average annual decline in CHD mortality rates for local authorities in the most and least deprived quintiles overlap considerably.


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)

Association between average annual percentage decline in coronary heart disease (CHD) mortality rates between 1994 and 2008 and 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

fig4: Association between average annual percentage decline in coronary heart disease (CHD) mortality rates between 1994 and 2008 and deprivation, Great Britain—men younger than 75 years.
Mentions: Figure 4 shows the association between average annual decline in men younger than 75 years CHD mortality rates and deprivation for all local authorities in Great Britain. The variables demonstrate a weak association (r2=0.06, p<0.001). The association suggests that more deprived areas have a slower rate of decline in relative CHD mortality rates than more affluent areas. However, the weak association suggests that the level of deprivation of the local authority alone does little to describe the variance in decline in CHD mortality rates. This is the case for both men and women younger than 75 years CHD mortality rates and is demonstrated in table 1, where the IQR of average annual decline in CHD mortality rates for local authorities in the most and least deprived quintiles overlap considerably.

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