C Rumble1, D J Pevalin. 1. School of Health and Human Sciences, University of Essex, Colchester CO4 3SQ, UK.
Abstract
OBJECTIVES: Cardiovascular disease is a major cause of morbidity and mortality for which there are many modifiable risk factors. This study investigated changes in social inequalities of cardiovascular disease risk factors amongst men aged 20-64 years in England between 1998 and 2006. STUDY DESIGN: Repeated cross-sectional study. METHODS: Health Survey for England data from 1998, 2003 and 2006 were used. The following physiological risk factors were considered: body mass index, waist-to-hip ratio, blood pressure and total serum cholesterol level. The behavioural risk factors considered were limited physical exercise, smoking status and level of social support. The National Statistics Socio-economic Classification was used to measure socio-economic position. An index of inequality for each risk factor was calculated, and change in inequality over time was assessed by t-tests. RESULTS: Significant cross-sectional inequality was found for waist-to-hip ratio, systolic blood pressure, smoking, limited physical exercise and social support at one or more time points. Between 1998 and 2006, there was a significant increase in inequality for smoking status [relative index of inequality (RII) 4.06-6.65 (t-test: 2.88, P = 0.003)] and limited physical exercise [RII 1.06-1.74 (t-test: 2.92, P = 0.003)]; these increases in inequality over time were due to improvements for those in higher socio-economic classes. CONCLUSIONS: Policies have not had the desired impact of reducing inequalities. Although the long-term effects of these policies might not yet be apparent, available evidence needs to be used to monitor impact and direct policy change to address the possibility of widening inequalities.
OBJECTIVES:Cardiovascular disease is a major cause of morbidity and mortality for which there are many modifiable risk factors. This study investigated changes in social inequalities of cardiovascular disease risk factors amongst men aged 20-64 years in England between 1998 and 2006. STUDY DESIGN: Repeated cross-sectional study. METHODS: Health Survey for England data from 1998, 2003 and 2006 were used. The following physiological risk factors were considered: body mass index, waist-to-hip ratio, blood pressure and total serum cholesterol level. The behavioural risk factors considered were limited physical exercise, smoking status and level of social support. The National Statistics Socio-economic Classification was used to measure socio-economic position. An index of inequality for each risk factor was calculated, and change in inequality over time was assessed by t-tests. RESULTS: Significant cross-sectional inequality was found for waist-to-hip ratio, systolic blood pressure, smoking, limited physical exercise and social support at one or more time points. Between 1998 and 2006, there was a significant increase in inequality for smoking status [relative index of inequality (RII) 4.06-6.65 (t-test: 2.88, P = 0.003)] and limited physical exercise [RII 1.06-1.74 (t-test: 2.92, P = 0.003)]; these increases in inequality over time were due to improvements for those in higher socio-economic classes. CONCLUSIONS: Policies have not had the desired impact of reducing inequalities. Although the long-term effects of these policies might not yet be apparent, available evidence needs to be used to monitor impact and direct policy change to address the possibility of widening inequalities.
Authors: Carlos Álvarez-Fernández; Manuel Vaquero-Abellán; África Ruíz-Gandara; Manuel Romero-Saldaña; Carlos Álvarez-López Journal: Aten Primaria Date: 2016-07-14 Impact factor: 1.137