Key result
Low socioeconomic status was associated with higher cardiometabolic risk in Czechia (OR 1.45; 95% CI 1.01-2.21 for low education) and Venezuelan women, but lower risk in Venezuelan men.
Why the study?
Relationships between social determinants and cardiometabolic risk across different socioeconomic contexts, such as sociopolitically unstable Venezuela and stable Czechia, had not been directly compared.
Does the association between socioeconomic status and cardiometabolic risk differ between sociopolitically unstable Venezuela and stable Czechia?
Cross-Sectional (n=3,231)
Yes
Does the association between socioeconomic status and cardiometabolic risk differ between sociopolitically unstable Venezuela and stable Czechia?
The association between socioeconomic status and cardiometabolic risk varies significantly by country and sex, highlighting the impact of different sociopolitical environments on health.
SES-cardiometabolic risk associations vary by country and sex; hypothesis-generating for sociopolitical context effects, should not yet change practice.
OBJECTIVES: This study compared the relationships of social determinants with cardiometabolic risk in different socioeconomic contexts: sociopolitically unstable Venezuela (VE) and stable Czechia (CZ). DESIGN: cross-sectional analysis involving two population-based studies. SETTING: Brno, Czechia and 23 cities of Venezuela. PARTICIPANTS: 25-64 years old subjects from CZ (2013-2014, n=1579, 56% females) and VE (2014-2017, n=1652, 70% females). MAIN OUTCOME MEASURES: The composite cardiometabolic risk score (CMRS) (scaled 0-8) was calculated using eight biomarkers (body mass index, waist circumference, blood glucose, systolic and diastolic blood pressure, total and high-density lipoprotein-cholesterol, triglycerides). Social characteristics included education in both countries, income in CZ and a composite measure of social position (SP) in VE. Sex stratified ordinal regression examined the social gradient in having less favourable CMRS. RESULTS: In CZ, men and women with low education and women with low income had higher odds of higher CMRS compared with those with high education and income with OR 1.45 (95% CI 1.01 to 2.21), 2.29 (95% CI 1.62 to 3.24) and 1.69 (95% CI 1.23 to 2.35). In VE, women with low education and low SP had higher odds to have higher CMRS OR 1.47 (95% CI 1.09 to 1.97) and 1.51 (95% CI 1.16 to 1.97), while men with low education and low SP had lower odds to have higher CMRS OR 0.64 (95% CI 0.41 to 1.00) and 0.61 (95% CI 0.40 to 0.97), compared with those with high education and high SP. Independently of age, sex and socioeconomic characteristics, Venezuelans had higher odds to have higher CMRS than Czechs (OR 2.70; 95% CI 2.37 to 3.08). CONCLUSIONS: The results suggest that the associations of socioeconomic status indices and cardiometabolic risk differed between CZ and VE, likely reflecting differences in the social environment among countries. Further research is needed to confirm and quantify these differences.
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Polcrová et al. (2023) conducted a cross-sectional in Cardiometabolic risk (n=3,231). Low socioeconomic status (education, income, or social position) vs. High socioeconomic status was evaluated on Higher composite cardiometabolic risk score (CMRS) (OR 1.45, 95% CI 1.01-2.21). Low socioeconomic status was associated with higher cardiometabolic risk in Czechia (OR 1.45; 95% CI 1.01-2.21 for low education) and Venezuelan women, but lower risk in Venezuelan men.
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