Key result
Blue-collar social environment linked to ~18% higher cardiac infarction risk in middle-aged men.
Why the study?
Conventional risk factors only partly explain the social gradient in cardiovascular diseases, necessitating comparison of disease occurrence in different social environments.
Does social environment (blue-collar vs white-collar city) affect the occurrence of cardiovascular disease and mortality in the general population?
Observational (n=93,881)
Does social environment (blue-collar vs white-collar city) affect the occurrence of cardiovascular disease and mortality in the general population?
Relative Risk: 1.18 (95% CI 1.03–1.36)
Absolute Event Rate: 26.7% vs 22.5%
p-value: p=0.05
Social environment significantly impacts cardiovascular morbidity and mortality, highlighting the need for targeted community public health interventions in lower socioeconomic areas.
Higher CVD morbidity and mortality in the blue-collar twin city signals enduring social disparities; leaves open whether targeted community interventions can narrow gaps.
BACKGROUND: Cardiovascular diseases estimate to be the leading cause of death and loss of disability-adjusted life years globally. Conventional risk factors for cardiovascular diseases only partly account for the social gradient. The purpose of this study was to compare the occurrence of the most frequent cardiovascular diseases and cardiovascular mortality in two close cities, the Twin cities. METHODS: We focused on the total population in two neighbour and equally sized cities with a population of around 135 000 inhabitants each. These twin cities represent two different social environments in the same Swedish county. According to their social history they could be labelled a "blue-collar" and a "white-collar" city. Morbidity data for the two cities was derived from an administrative health care register based on medical records assigned by the physicians at both hospitals and primary care. The morbidity data presented are cumulative incidence rates and the data on mortality for ischemic heart diseases is based on official Swedish statistics. RESULTS: The cumulative incidence of different cardiovascular diagnoses for younger and also elderly men and women revealed significantly differences for studied cardiovascular diagnoses. The occurrence rates were in all aspects highest in the population of the "blue-collar" twin city for both sexes. CONCLUSIONS: This study revealed that there are significant differences in risk for cardiovascular morbidity and mortality between the populations in the studied different social environments. These differences seem to be profound and stable over time and thereby give implication for public health policy to initiate a community intervention program in the "blue-collar" twin city.
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Wennerholm et al. (2011) conducted an observational in Cardiovascular diseases (n=93,881). Living in a 'blue-collar' social environment vs. Living in a 'white-collar' social environment was evaluated on Cardiac infarction (men aged 45-64 years) (RR 1.18, 95% CI 1.03-1.36, p=0.05). Living in a blue-collar social environment was associated with significantly higher cumulative incidence rates of cardiovascular diseases, including an 18% increased risk of cardiac infarction among men aged 45-64 years compared to a white-collar environment.
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