Low socioeconomic position was associated with 2.1-2.2 times higher age-adjusted odds of coronary heart disease compared to high-income groups, which was only partially attenuated by risk factors.
Cross-Sectional (n=48,592)
Does low socioeconomic position increase the risk of coronary heart disease independent of behavior-related risk factors in adults?
Socioeconomic differences in coronary heart disease risk are only partially explained by traditional behavior-related risk factors, suggesting interventions targeting these factors alone will not eliminate the socioeconomic gradient.
Effect estimate: OR 2.1-2.2
OBJECTIVES: We examined the associations between socioeconomic position, co-occurrence of behavior-related risk factors, and the effect of these factors on the relative and absolute socioeconomic gradients in coronary heart disease. METHODS: We obtained the socioeconomic position of 9337 men and 39,255 women who were local government employees aged 17-65 years from employers' records (the Public Sector Study, Finland). A questionnaire survey in 2000-2002 was used to collect data about smoking, heavy alcohol consumption, physical inactivity, obesity, and prevalence of coronary heart disease (myocardial infarction or angina diagnosed by a doctor). RESULTS: The age-adjusted odds of coronary heart disease were 2.1-2.2 times higher for low-income groups than high-income groups for both men and women, and adjustment for risk factors attenuated these associations by 13%-29%. There was no further attenuation with additional adjustment for the number of co-occurring risk factors, although socioeconomic disadvantage was associated with the co-occurrence of multiple risk factors. The absolute difference in coronary heart disease risk between socioeconomic groups could not be attributed to the measured risk factors. CONCLUSIONS: Interventions to reduce adult behavior-related risk factors may not completely remove socioeconomic differences in relative or absolute coronary heart disease risk, although they would lessen these effects.
Kivimäki et al. (2007) conducted a cross-sectional in Coronary heart disease (n=48,592). Low socioeconomic position vs. High socioeconomic position was evaluated on Prevalence of coronary heart disease (myocardial infarction or angina diagnosed by a doctor) (OR 2.1-2.2). Low socioeconomic position was associated with 2.1-2.2 times higher age-adjusted odds of coronary heart disease compared to high-income groups, which was only partially attenuated by risk factors.