Large health disparities in cardiovascular death in men and women, by ethnicity and socioeconomic status in an urban based population cohort
Background: Socioeconomic status and ethnicity are not incorporated as predictors in country-level cardiovascular risk charts on mainland Europe. The aim of this study was to quantify the sex-specific cardiovascular death rates stratified by ethnicity and socioeconomic factors in an urban population...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-10-01
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| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537021004004 |
| _version_ | 1818722352607789056 |
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| author | Janet M. Kist Gideon W.G. Smit Albert T.A. Mairuhu Jeroen N. Struijs Rimke C. Vos Petra G. van Peet Hedwig M.M. Vos Edith D. Beishuizen Yvo W.J. Sijpkens Rolf H.H. Groenwold Mattijs E. Numans |
| author_facet | Janet M. Kist Gideon W.G. Smit Albert T.A. Mairuhu Jeroen N. Struijs Rimke C. Vos Petra G. van Peet Hedwig M.M. Vos Edith D. Beishuizen Yvo W.J. Sijpkens Rolf H.H. Groenwold Mattijs E. Numans |
| author_sort | Janet M. Kist |
| collection | DOAJ |
| description | Background: Socioeconomic status and ethnicity are not incorporated as predictors in country-level cardiovascular risk charts on mainland Europe. The aim of this study was to quantify the sex-specific cardiovascular death rates stratified by ethnicity and socioeconomic factors in an urban population in a universal healthcare system. Methods: Age-standardized death rates (ASDR) were estimated in a dynamic population, aged 45–75 in the city of The Hague, the Netherlands, over the period 2007–2018, using data of Statistics Netherlands. Results were stratified by sex, ethnicity (country of birth) and socioeconomic status (prosperity) and compared with a European cut-off for high-risk countries (ASDR men 225/100,000 and women 175/100,000). Findings: In total, 3073 CVD deaths occurred during 1·76 million person years follow-up. Estimated ASDRs (selected countries of birth) ranged from 126 (95%CI 89–174) in Moroccan men to 379 (95%CI 272–518) in Antillean men, and from 86 (95%CI 50–138) in Moroccan women to 170 (95%CI 142–202) in Surinamese women. ASDRs in the highest and lowest prosperity quintiles were 94 (95%CI 90–98) and 343 (95%CI 334–351) for men, and 43 (95%CI 41–46) and 140 (95%CI 135–145), for women, respectively. Interpretation: In a diverse urban population, large health disparities in cardiovascular ASDRs exists across ethnic and socioeconomic subgroups. Identifying these high-risk subgroups followed by targeted preventive efforts, might provide a basis for improving cardiovascular health equity within communities. Instead of classifying countries as high-risk or low-risk, a shift towards focusing on these subgroups within countries might be needed. Funding: Leiden University Medical Center and Leiden University |
| first_indexed | 2024-12-17T20:53:16Z |
| format | Article |
| id | doaj.art-5fc96d4437994ff28b97d0124d5e15f0 |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-12-17T20:53:16Z |
| publishDate | 2021-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-5fc96d4437994ff28b97d0124d5e15f02022-12-21T21:32:57ZengElsevierEClinicalMedicine2589-53702021-10-0140101120Large health disparities in cardiovascular death in men and women, by ethnicity and socioeconomic status in an urban based population cohortJanet M. Kist0Gideon W.G. Smit1Albert T.A. Mairuhu2Jeroen N. Struijs3Rimke C. Vos4Petra G. van Peet5Hedwig M.M. Vos6Edith D. Beishuizen7Yvo W.J. Sijpkens8Rolf H.H. Groenwold9Mattijs E. Numans10Department of Public Health & Primary Care, Leiden University Medical Center, Campus The Hague, the Netherlands; Corresponding author.Department of Public Health & Primary Care, Leiden University Medical Center, Campus The Hague, the NetherlandsDepartment of Internal Medicine, HAGA Teaching Hospital, The Hague, the NetherlandsDepartment of Public Health & Primary Care, Leiden University Medical Center, Campus The Hague, the Netherlands; National Institute for Public Health and the Environment, Bilthoven, the NetherlandsDepartment of Public Health & Primary Care, Leiden University Medical Center, Campus The Hague, the NetherlandsDepartment of Public Health & Primary Care, Leiden University Medical Center, Campus The Hague, the NetherlandsDepartment of Public Health & Primary Care, Leiden University Medical Center, Campus The Hague, the NetherlandsDepartment Internal Medicine, HMC Hospital, The Hague, the NetherlandsDepartment Internal Medicine, HMC Hospital, The Hague, the NetherlandsDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Biomedical Data Science, Leiden University Medical Center, Leiden, the NetherlandsDepartment of Public Health & Primary Care, Leiden University Medical Center, Campus The Hague, the NetherlandsBackground: Socioeconomic status and ethnicity are not incorporated as predictors in country-level cardiovascular risk charts on mainland Europe. The aim of this study was to quantify the sex-specific cardiovascular death rates stratified by ethnicity and socioeconomic factors in an urban population in a universal healthcare system. Methods: Age-standardized death rates (ASDR) were estimated in a dynamic population, aged 45–75 in the city of The Hague, the Netherlands, over the period 2007–2018, using data of Statistics Netherlands. Results were stratified by sex, ethnicity (country of birth) and socioeconomic status (prosperity) and compared with a European cut-off for high-risk countries (ASDR men 225/100,000 and women 175/100,000). Findings: In total, 3073 CVD deaths occurred during 1·76 million person years follow-up. Estimated ASDRs (selected countries of birth) ranged from 126 (95%CI 89–174) in Moroccan men to 379 (95%CI 272–518) in Antillean men, and from 86 (95%CI 50–138) in Moroccan women to 170 (95%CI 142–202) in Surinamese women. ASDRs in the highest and lowest prosperity quintiles were 94 (95%CI 90–98) and 343 (95%CI 334–351) for men, and 43 (95%CI 41–46) and 140 (95%CI 135–145), for women, respectively. Interpretation: In a diverse urban population, large health disparities in cardiovascular ASDRs exists across ethnic and socioeconomic subgroups. Identifying these high-risk subgroups followed by targeted preventive efforts, might provide a basis for improving cardiovascular health equity within communities. Instead of classifying countries as high-risk or low-risk, a shift towards focusing on these subgroups within countries might be needed. Funding: Leiden University Medical Center and Leiden Universityhttp://www.sciencedirect.com/science/article/pii/S2589537021004004Cardiovascular deathethnicitysocioeconomic statushealth disparitieshealth equity |
| spellingShingle | Janet M. Kist Gideon W.G. Smit Albert T.A. Mairuhu Jeroen N. Struijs Rimke C. Vos Petra G. van Peet Hedwig M.M. Vos Edith D. Beishuizen Yvo W.J. Sijpkens Rolf H.H. Groenwold Mattijs E. Numans Large health disparities in cardiovascular death in men and women, by ethnicity and socioeconomic status in an urban based population cohort EClinicalMedicine Cardiovascular death ethnicity socioeconomic status health disparities health equity |
| title | Large health disparities in cardiovascular death in men and women, by ethnicity and socioeconomic status in an urban based population cohort |
| title_full | Large health disparities in cardiovascular death in men and women, by ethnicity and socioeconomic status in an urban based population cohort |
| title_fullStr | Large health disparities in cardiovascular death in men and women, by ethnicity and socioeconomic status in an urban based population cohort |
| title_full_unstemmed | Large health disparities in cardiovascular death in men and women, by ethnicity and socioeconomic status in an urban based population cohort |
| title_short | Large health disparities in cardiovascular death in men and women, by ethnicity and socioeconomic status in an urban based population cohort |
| title_sort | large health disparities in cardiovascular death in men and women by ethnicity and socioeconomic status in an urban based population cohort |
| topic | Cardiovascular death ethnicity socioeconomic status health disparities health equity |
| url | http://www.sciencedirect.com/science/article/pii/S2589537021004004 |
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