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Cited by 222Health disparities and outcomesCardiovascular Health and Risk FactorsHealthcare Systems and Public Health

Inequities in CHD Incidence and Case Fatality by Neighborhood Deprivation

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Winkleby, Marilyn, Sundquist, Kristina, Cubbin, Catherine·2007·American Journal of Preventive Medicine
DOI 10.1016/j.amepre.2006.10.002PMC PMC2225531
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Abstract

Background Research has not firmly established whether living in a deprived neighborhood predicts the incidence and case fatality of coronary heart disease (CHD), and whether effects vary across sociodemographic groups. Methods Prospective follow-up study of all Swedish women and men, aged 35 to 74 (1.9 million women, 1.8 million men). Women and men, without a history of CHD, were assessed on December 31, 1995, and followed from January 1, 1996 through December 31, 2000, for first fatal or nonfatal CHD event (130,024 cases); data were analyzed in 2006. Neighborhood-level deprivation (index of education, income, unemployment, welfare assistance) was categorized as low, moderate, and high deprivation. Results Age-standardized CHD incidence was 1.9 times higher for women and 1.5 times higher for men in high- versus low-deprivation neighborhoods; 1-year case fatality from CHD was 1.6 times higher for women and 1.7 times higher for men in high versus low deprivation neighborhoods. The higher incidence in more deprived neighborhoods was observed across all individual-level sociodemographic groups (age, marital status, family income, education, immigration status, mobility, and urban/rural status). In multilevel logistic regression models, neighborhood deprivation remained significantly associated with both CHD incidence and case fatality for women and men after adjusting for the seven sociodemographic factors (p values <0.01). Effects were slightly stronger for women than men in an ancillary analysis that tested for gender differences. Conclusions The clustering of CHD and subsequent mortality among adults in deprived neighborhoods raises important clinical and public health concerns, and calls for a reframing of health problems to include neighborhood social environments, as they may affect health.

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Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Socioeconomic status is inversely associated with all phases of CVD progression, from the onset of risk factors through mortality due to CVD.

    “The inverse association of socioeconomic status (SES) with all phases of the progression of CVD is well established, from the onset of risk factors through mortality due to CVD [41-45].”

    From Prevalence of cardiovascular disease among Asian, Pacific Islander and multi-race populations in Hawai’i and California (2023) · cites this paper as [43]

    The Abstract (page not supplied) reports higher CHD incidence and one-year case fatality in more deprived neighborhoods, supporting the association for those outcomes. The paper does not establish an association across all phases of CVD progression: it does not measure the onset of risk factors, and its outcomes concern CHD rather than all CVD. (LLM, conf=0.88)

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2 of the 48 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. Pickett KE, Pearl M. Multilevel analyses of neighborhood socioeconomic context and health outcomes: a critical review. J Epidemiol Community Health 2001;55:111-22.
  2. Kaplan GA. What is the role of the social environment in understanding inequalities in health? Ann N Y Acad Sci 1999;896:116 -9.
  3. Callas PW, Pastides H, Hosmer DW. Empirical comparisons of proportional hazards, poisson, and logistic regression modeling of occupational cohort data. Am J Ind Med 1998;33:33-47.

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Authors
Winkleby, M., Sundquist, K., & Cubbin, C.
Affiliations
  • Stanford Medicine (US)
  • Karolinska Institutet (SE)
  • University of California, San Francisco (US)
Corresponding author
Winkleby, Marilyn
ORCID
Venue
American Journal of Preventive Medicine
Publisher
Elsevier BV
Published
2007-02
Volume
32
Issue
2
Pages
97-106
ISSN
0749-3797 (ISSN-L)
DOI
10.1016/j.amepre.2006.10.002
PMC
PMC2225531
OpenAlex
W2090289324
Cited by
222
References
48
Citations by year
2026: 3 · 2025: 9 · 2024: 8 · 2023: 13 · 2022: 10 · 2021: 7 · 2020: 6 · 2019: 10 · 2018: 12 · 2017: 14 · 2016: 12 · 2015: 14 · 2014: 15 · 2013: 16 · 2012: 15
FWCI
15.12
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • American Journal of Preventive Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Vetenskapsrådet (K2005-27X-15428-01A)
  • National Heart, Lung, and Blood Institute (R01 HL71084, R01HL071084)
Topics
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
  • Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
Keywords
coronary artery disease, neighborhood disadvantage, socioeconomic status, CHD incidence, health disparities, gender differences, sociodemographic factors, social environment, multilevel analysis
MeSH terms
Adult, Aged, Coronary Disease, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Social Class, Sweden

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