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Socioeconomic position and cardiovascular mortality in 63 million adults from Brazil.
Mallinson, Poppy Alice Carson; Luhar, Shammi; Williamson, Elizabeth; Barreto, Mauricio L; Kinra, Sanjay.
Afiliação
  • Mallinson PAC; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK poppy.mallinson1@lshtm.ac.uk.
  • Luhar S; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
  • Williamson E; Department of Public Health and Primary Care, University of Cambridge, Cambridge, Cambridgeshire, UK.
  • Barreto ML; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
  • Kinra S; Centre for Data and Knowledge Integration for Health (CIDACS), Fiocruz Bahia, Salvador, Bahia, Brazil.
Heart ; 107(10): 822-827, 2021 05.
Article em En | MEDLINE | ID: mdl-33483354
BACKGROUND: It has been suggested that cardiovascular disease exhibits a 'social cross-over', from greater risk in higher socioeconomic groups to lower socioeconomic groups, on economic development, but robust evidence is lacking. We used standardised data to compare the social inequalities in cardiovascular mortality across states at varying levels of economic development in Brazil. METHODS: We used national census and mortality data from 2010. We used age-adjusted multilevel Poisson regression to estimate the association between educational status and cardiovascular mortality by state-level economic development (assessed by quintiles of Human Development Index). RESULTS: In 2010, there were 185 383 cardiovascular deaths among 62.5 million adults whose data were analysed. The age-adjusted cardiovascular mortality rate ratio for women with <8 years of education (compared with 8+ years) was 3.75 (95% CI 3.29 to 4.28) in the least developed one-fifth of states and 2.84 (95% CI 2.75 to 2.92) in the most developed one-fifth of states (p value for linear trend=0.002). Among men, corresponding rate ratios were 2.53 (95% CI 2.32 to 2.77) and 2.26 (95% CI 2.20 to 2.31), respectively (p value=0.258). Associations were similar across subtypes of cardiovascular disease (ischaemic heart disease and stroke) and robust to the size of geographical unit used for analysis. CONCLUSIONS: Our results do not support a 'social crossover' in cardiovascular mortality on economic development. Our analyses, based on a large standardised dataset from a country that is currently experiencing economic transition, provide strong evidence that low socioeconomic groups experience the highest risk of cardiovascular disease, irrespective of the stage of national economic development.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Classe Social / Doenças Cardiovasculares / Escolaridade Tipo de estudo: Observational_studies / Prevalence_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Heart Assunto da revista: CARDIOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de publicação: Reino Unido
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Classe Social / Doenças Cardiovasculares / Escolaridade Tipo de estudo: Observational_studies / Prevalence_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Heart Assunto da revista: CARDIOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de publicação: Reino Unido