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Cited by 62Health Promotion and Cardiovascular PreventionHealth disparities and outcomesGlobal Cancer Incidence and Screening

Impact of socioeconomic deprivation on screening for cardiovascular disease risk in a primary prevention population: a cross-sectional study

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Lang, Sarah-Jane, Abel, Gary A, Mant, Jonathan, Mullis, Ricky·2016·BMJ Open
DOI 10.1136/bmjopen-2015-009984PMC PMC4809080
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Abstract

Objectives: Investigate the association between socioeconomic deprivation and completeness of cardiovascular disease (CVD) risk factor recording in primary care, uptake of screening in people with incomplete risk factor recording and with actual CVD risk within the screened subgroup. Design: Cross-sectional study. Setting: Nine UK general practices. Participants: 7987 people aged 50–74 years with no CVD diagnosis. Methods: CVD risk was estimated using the Framingham equation from data extracted from primary care electronic health records. Where there was insufficient information to calculate risk, patients were invited to attend a screening assessment. Analysis: Proportion of patients for whom clinical data were sufficiently complete to enable CVD risk to be calculated; proportion of patients invited to screening who attended; proportion of patients who attended screening whose 10-year risk of a cardiovascular event was high (>20%). For each outcome, a set of logistic regression models were run. Crude and adjusted ORs were estimated for person-level deprivation, age, gender and smoking status. We included practice-level deprivation as a continuous variable and practice as a random effect to account for clustering. Results: People who had lower Indices of Multiple Deprivation (IMD) scores (less deprived) had significantly worse routine CVD risk factor recording (adjusted OR 0.97 (0.95 to 1.00) per IMD decile; p=0.042). Screening attendance was poorer in those with more deprivation (adjusted OR 0.89 (0.86 to 0.91) per IMD decile; p<0.001). Among those who attended screening, the most deprived were more likely to have CVD risk >20% (OR 1.09 (1.03 to 1.15) per IMD decile; p=0.004). Conclusions: Our data suggest that those who had the most to gain from screening were least likely to attend, potentially exacerbating existing health inequalities. Future research should focus on tailoring the delivery of CVD screening to ensure engagement of socioeconomically deprived groups.

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  • Additional studies found that socioeconomically deprived individuals were less likely to receive CVD preventive screening, but these studies were performed outside the U.S. and did not stratify individuals by existing CVD status.

    “Additional studies examining preventive screening for CVD have found that socioeconomically deprived individuals were less likely to receive CVD preventive screening, but these studies were performed in countries outside of the U.S. and also did not stratify individuals based on existing CVD status [29], [30], [31].”

    From Income disparity and utilization of cardiovascular preventive care services among U.S. adults (2021) · cites this paper as [29]

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Cited by

Sorted by citations

Authors
Lang, S.-J., Abel, G. A., Mant, J., & Mullis, R.
Affiliations
University of Cambridge (GB)
Corresponding author
Mullis, Ricky
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2016-03
Volume
6
Issue
3
Pages
e009984
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2015-009984
PMC
PMC4809080
OpenAlex
W2333650076
Cited by
62
References
1
Citations by year
2026: 7 · 2025: 10 · 2024: 10 · 2023: 6 · 2022: 5 · 2021: 8 · 2020: 6 · 2019: 7 · 2018: 3
FWCI
3.31
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • BMJ Open (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Apollo (University of Cambridge) (submittedVersion, cc-by)
  • Figshare (submittedVersion)
  • HighWire Press Open Archive (submittedVersion)
  • Open Research Exeter (University of Exeter) (submittedVersion)
  • Apollo (cc-by)
Funders
National Institute for Health Research (RP-PG-0606-1153)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
Keywords
socioeconomic deprivation, cardiovascular screening, primary prevention, screening uptake, health disparities, Index of Multiple Deprivation, Framingham risk equation, primary care, middle-aged and older adults
MeSH terms
Aged, Cardiovascular Diseases, Cross-Sectional Studies, Female, United Kingdom, Humans, Male, Mass Screening, Middle Aged, Primary Prevention, Risk Factors, Socioeconomic Factors, Logistic Models, Health Status Disparities

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