Key result
Higher income linked to gaining ~0.8 more MI-free life years over time versus low income.
Why the study?
Evidence was lacking on how social inequalities in myocardial infarction incidence and mortality risks developed over time, and how this affected lifespan free of and after MI across social subgroups.
Observational
Income inequalities in the lifespan spent free of MI and after MI have widened over time, with low-income individuals not gaining MI-free life years despite overall improvements.
Answers are grounded in this paper and cite their sources.
Socioeconomic disparities may require targeted MI prevention in low-income groups; leaves open whether interventions can reverse widening gaps.
BACKGROUND: Despite substantial improvements in prevention and therapy, myocardial infarction (MI) remains a frequent health event, causing high mortality and serious health impairments. Previous research lacks evidence on how social inequalities in incidence and mortality risks developed over time, and on how these developments affect the lifespan free of MI and after MI in different social subgroups. This study investigates income inequalities in MI-free life years and life years after MI and whether these inequalities widened or narrowed over time. METHODS: The analyses are based on claims data of a large German health insurance provider insuring approximately 2.8 million individuals in the federal state Lower Saxony. Trends in income inequalities in incidence and mortality were assessed for all subjects aged 60 years and older by comparing the time periods 2006-2008 and 2015-2017 using multistate survival models. Trends in the number of life years free of MI and after MI were calculated separately for income groups by applying multistate life table analyses. RESULTS: MI incidence and mortality risks decreased over time, but declines were strongest among men and women in the higher-income group. While life years free of MI increased in men and women with higher incomes, no MI-free life years were gained in the low-income group. Among men, life years after MI increased irrespective of income group. CONCLUSIONS: Income inequalities in the lifespan spent free of MI and after MI widened over time. In particular, men with low incomes are disadvantaged, as life years spent after MI increased, but no life years free of MI were gained.
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Tetzlaff et al. (2021) conducted an observational in Myocardial infarction. Higher income (>60% of average income) vs. Low income (≤60% of average income) was evaluated on Myocardial infarction incidence (Men) (HR 0.86, 95% CI 0.84-0.89).
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