scholarly journals The individual and combined associations of depression and socioeconomic status with risk of major cardiovascular events: a prospective cohort study

2022 ◽  
Author(s):  
Regina Prigge ◽  
Sarah H Wild ◽  
Caroline A Jackson
Keyword(s):  
Socioeconomic Status ◽  
Cohort Study ◽  
Low Income ◽  
Prospective Cohort ◽  
Cardiovascular Events ◽  
Low Ses ◽  
Major Cardiovascular Events ◽  
High Area ◽  
Low Education ◽  
The Individual

Objective: We aimed to investigate the individual and combined associations of depression and low socioeconomic status (SES) with risk of major cardiovascular events (MCVE), defined as first-ever fatal or non-fatal stroke or myocardial infarction, in a large prospective cohort study. Methods: We used data from 466,238 UK Biobank participants, aged 40 - 69 years without cardiovascular disease, bipolar disorder or schizophrenia at baseline. We performed Cox proportional hazard models to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CI) of the individual and combined associations of depression and each of educational attainment, area-based deprivation and income with risk of MCVE. We assessed effect modification and explored interaction on the additive and multiplicative scale. Results: Depression, low education, high area-based deprivation and low income were individually associated with increased risks of MCVE (adjusted HR, 95% CI: 1.28, 1.19 - 1.38; 1.20, 1.14 - 1.27; 1.17, 1.11 - 1.23; and 1.22, 1.16 - 1.29, respectively). Depression was associated with increased risks of MCVE among individuals with high and low SES. Individuals with depression and each of low education, high area-based deprivation and low income were at particularly high risk of MCVE (HR, 95% CI: 1.50, 1.38 - 1.63; 1.63, 1.46 - 1.82; 1.31, 1.23 - 1.40, respectively). There was interaction between depression and area-based deprivation on multiplicative and additive scales but no interaction with education or income. Conclusion: Depression was associated with increased risks of MCVE among individuals with high and low SES, with particularly high risks among those living in areas of high deprivation.

Abstract MP47: The Association of Socioeconomic Status with Subclinical Myocardial Damage

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Anna E Fretz ◽  
Andrea L Schneider ◽  
John McEvoy ◽  
Ron Hoogeveen ◽  
Christie M Ballantyne ◽  
...  
Keyword(s):  
Risk Factors ◽  
Socioeconomic Status ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Low Income ◽  
Myocardial Damage ◽  
Low Ses ◽  
12Th Grade ◽  
Low Education ◽  
Prevalence Ratios

Background: The association between socioeconomic status (SES) and clinical cardiovascular events is well established. However, little is known about the relationship between SES and subclinical myocardial damage, as assessed by a novel highly sensitive assay for cardiac troponin T (hs-cTnT). Methods: We conducted a cross-sectional analysis of 11,411 participants from the ARIC Study with no history of cardiovascular disease who had hs-cTnT measured at visit 2 (1990-1992). SES was defined using either annual household income, categorized as: low (<$16,000), mid-level ($16,000 - $34,999), high (≥ $35,000), or lifetime educational attainment, categorized as: low (<12th grade), mid-level (12th grade/some college) and high (college degree or higher). hs-cTnT was categorized as non-elevated (<14 ng/L) and elevated (≥ 14ng/L). Poisson regression was used to generate prevalence ratios for elevated hs-cTnT, separately by level of income and education after adjusting for demographic, clinical, and behavioral factors. Results: Persons with low income or low education were more likely to have subclinical myocardial damage as assessed by elevated hs-cTnT (≥14ng/L). Adjusted prevalence ratios for elevated troponin comparing low to high levels of income and education were 1.74 (95% CI: 1.32, 2.29) and 1.54 (95% CI: 1.21, 1.97), respectively (Table, Model 1). These results were slightly attenuated, but remained statistically significant after adjusting for cardiovascular risk factors and health behaviors (Models 2 and 3). Race-stratified results demonstrate a somewhat stronger and only significant association of low education with subclinical myocardial damage in blacks compared to whites (PR 1.83 vs 1.05, p-interaction =0.08). There was no race interaction with income (p-interaction =0.33). Conclusions: Low SES was associated with elevated hs-cTnT, independent of cardiovascular risk factors, especially in blacks. Further research is needed to explore how low SES contributes to subclinical myocardial damage.

scholarly journals Does religious involvement affect mortality in low-income Americans? A prospective cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e028200 ◽  
Author(s):  
Wanqing Wen ◽  
David Schlundt ◽  
Shaneda Warren Andersen ◽  
William J Blot ◽  
Wei Zheng
Keyword(s):  
Social Support ◽  
Socioeconomic Status ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Low Income ◽  
Prospective Cohort ◽  
Underserved Populations ◽  
Religious Involvement ◽  
Lifestyle Factors ◽  
Southeastern Usa

ObjectiveThis study aimed to evaluate the impacts of various forms of religious involvement, beyond individual socioeconomic status, lifestyle factors, emotional well-being and social support, on all-cause and cause-specific mortality in socioeconomic disadvantaged neighbourhoods.DesignThis is a prospective cohort study conducted from 2002 through 2015.SettingsThis study included underserved populations in the Southeastern USA.ParticipantsA total of nearly 85 000 participants, primarily low-income American adults, were enrolled. Eligible participants were aged 40–79 years at enrolment, spoke English and were not under treatment for cancer within the prior year.ResultsWe found that those who attended religious service attendance >1/week had 8% reduction in all-cause death and 15% reduction in cancer death relative to those who never attended. This association was substantially attenuated by depression score, social support, and socioeconomic and lifestyle covariates, and further attenuated by other forms of religious involvement. This association with all-cause mortality was found being stronger among those with higher socioeconomic status or healthier lifestyle behaviours.ConclusionOur results indicate that the association between religious services attendance >1/week and lower mortality was moderate but robust, and could be attenuated and modified by socioeconomic or lifestyle factors in this large prospective cohort study of underserved populations in the Southeastern USA.

scholarly journals Possible associations between callers’ degree-of-worry and their socioeconomic status when contacting out-of-hours services: a prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sita LeBlanc Thilsted ◽  
Fredrik Folke ◽  
Janne S. Tolstrup ◽  
Lau Caspar Thygesen ◽  
Hejdi Gamst-Jensen
Keyword(s):  
Socioeconomic Status ◽  
Patient Safety ◽  
Cohort Study ◽  
Marital Status ◽  
Household Income ◽  
Prospective Cohort ◽  
Low Ses ◽  
Telephone Triage ◽  
Annual Household Income ◽  
Out Of Hours

Abstract Background Telephone triage within out-of-hours (OOH) services aims to ascertain the urgency of a caller’s medical condition in order to determine the correct type of health care needed, ensuring patient safety. To improve the triage process by increasing patient-centred communication, a triage tool has been developed, whereby callers are asked to rate their degree-of-worry (DOW) as a measure of self-evaluated urgency. Studies show that low socioeconomic status (SES), being single and non-Western ethnicity are associated to low self-rated health and high morbidity and these factors may also be associated with high DOW. The aim of this paper was to examine if low SES, being single and non-Western ethnicity were associated to high DOW of callers contacting OOH services. Methods A prospective cohort study design, at the OOH services for the Capital Region of Denmark. Over 2 weeks, 6869 of 38,787 callers met the inclusion criteria: ≥18 years, patients themselves or close relative/friend, reported DOW, had a valid personal identification number and gave informed consent. Callers were asked to report their DOW (1 = minimal worry to 5 = maximal worry), which was dichotomized into low (1–3) and high (4, 5) DOW and linked to data from electronical medical records and Statistics Denmark. Socioeconomic factors (education and annual household income), marital status and ethnicity were assessed in relation to DOW by logistic regression. Results High DOW was reported by 38.2% of the participants. Low SES (low educational level; OR 1.5, 95% CI 1.3–1.7 and low annual household income; 1.5, 1.3–1.6) was associated with high DOW and so too was being single; 1.2, 1.1–1.3 and of non-Western ethnicity; 2.9, 2.5–3.4. Conclusions Knowledge of the association of low SES, marital status as single and non-Western ethnicity with high DOW among callers to OOH services may give call handlers a better understanding of callers’ DOW. If this does not correspond to the call handler’s perception of urgency, this knowledge may further encourage patient-centred communication, aid the triage process and increase patient safety. A better understanding of socioeconomic variables and their relation to callers’ DOW gives direction for future research to improve telephone triage of OOH services.

Associations of rural residence and low socioeconomic status on the risk of new onset cardiovascular disease (CVD) in cancer patients.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 90-90
Author(s):  
Atul Batra ◽  
Shiying Kong ◽  
Rodrigo Rigo ◽  
Winson Y. Cheung
Keyword(s):  
Socioeconomic Status ◽  
Educational Attainment ◽  
Cancer Patients ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
Low Ses ◽  
Rural Residence ◽  
Low Socioeconomic ◽  
Low Education

90 Background: Cancer patients are predisposed to CVD due to cancer treatments and shared risk factors (smoking/physical inactivity). We aimed to assess if rural residence and low socioeconomic status (SES) modify the risk of developing CVD. Methods: Patients diagnosed with non-metastatic solid organ cancers without baseline CVD in a large Canadian province from 2004 to 2017 were identified using the population-based registry. Postal codes were linked with Census data to determine rural residence as well as neighborhood-level income and educational attainment. Low income was defined as <46000 CAD/annum; low education was defined as a neighborhood in which <80% attended high school. Myocardial infarction, congestive heart failure, arrythmias and cerebrovascular accident constituted as CVD.We performed logistic regression analyses to examine the associations of rural residence and low SES with the development of CVD, adjusting for measured confounding variables. Results: We identified 81,275 patients diagnosed with cancer without pre-existing CVD. The median age was 62 years and 54.2% were women. The most prevalent cancer types included breast (28.6%), prostate (23.1%), and colorectal (14.9%). At a median follow-up of 68 months, 29.4% were diagnosed with new CVD. The median time from cancer diagnosis to CVD was 29 months. Rural patients (32.3 vs 28.4%,P < .001) and those with low income (30.4% vs 25.9%,P < .001) or low educational attainment (30.7% vs 27.6%,P < .001) experienced higher rates of CVD. After adjusting for baseline factors and treatment, rural residence (odds ratio[OR], 1.07; 95% confidence interval[CI], 1.04-1.11;P < .001), low income (OR,1.17;95%CI,1.12-1.21;P < .001) and low education (OR,1.08;95%CI,1.04-1.11;P < .001) continued to associate with higher odds of CVD. Further, patients with colorectal cancer were more likely to develop CVD compared with other tumors (OR,1.12;95% CI,1.04-1.16;P = .001). A multivariate Cox regression model showed that patients with low SES were more likely to die, but patients residing rurally were not. Conclusions: Approximately one-third of cancer survivors develop CVD on follow-up. Despite universal healthcare, marginalized populations experience different CVD risk profiles that should be considered when operationalizing lifestyle modification strategies and cardiac surveillance programs. [Table: see text]

scholarly journals Possible associations between callers’ degree-of-worry and their socioeconomic status when contacting out-of-hours services: a prospective cohort study

2020 ◽  
Author(s):  
Sita LeBlanc Thilsted ◽  
Hejdi Gamst-Jensen ◽  
Fredrik Folke ◽  
Janne S. Tolstrup ◽  
Lau Caspar Thygesen
Keyword(s):  
Socioeconomic Status ◽  
Patient Safety ◽  
Cohort Study ◽  
Marital Status ◽  
Household Income ◽  
Prospective Cohort ◽  
Low Ses ◽  
Telephone Triage ◽  
Annual Household Income ◽  
Out Of Hours

Abstract Background: Telephone triage within out-of-hours (OOH) services aims to ascertain the urgency of a caller’s medical condition in order to determine the correct type of health care needed, ensuring patient safety. To improve the triage process by increasing patient‐centred communication, a triage tool has been developed, whereby callers are asked to rate their degree-of-worry (DOW) as a measure of self-evaluated urgency. Studies show that low socioeconomic status (SES), being single and non-Western ethnicity are associated to low self-rated health and morbidity and these factors may also be associated with high DOW. The aim of this paper was to examine if low SES, being single and non-Western ethnicity were associated to high DOW of callers contacting OOH services. Methods: A prospective cohort study design, at the OOH services for the Capital Region of Denmark. Over two weeks, 6,869 of 38,787 callers met the inclusion criteria: ³18 years, patients themselves or close relative/friend, reported DOW, had a valid personal identification number and gave informed consent. Callers were asked to report their DOW (1=minimal worry to 5=maximal worry), which was dichotomized into low (1-3) and high (4-5) DOW and linked to data from electronical medical records and Statistics Denmark. Socioeconomic factors (education and annual household income), marital status and ethnicity were assessed in relation to DOW by logistic regression.Results: High DOW was reported by 38.2% of the participants. Low SES (low educational level; OR 1.5, 95% CI 1.3-1.7 and low annual household income; 1.5, 1.3-1.6) was associated with high DOW and so too was being single; 1.2, 1.1-1.3 and of non-Western ethnicity; 2.9, 2.5-3.4.Conclusions: Knowledge of the association of low SES, marital status as single and non-Western ethnicity with high DOW among callers to OOH services may give call handlers a better understanding of callers’ DOW. If this does not correspond to the call handler’s perception of urgency, this knowledge may further encourage patient-centred communication, aid the triage process and increase patient safety. A better understanding of socioeconomic variables and their relation to callers’ DOW gives direction for future research to improve telephone triage of OOH services.

Abstract 253: The Association of Socioeconomic Status With Elevation of N-terminal Pro-b-type Natriuretic Peptide

2016 ◽  
Vol 9 (suppl_2) ◽  
Author(s):  
Priya Vart ◽  
Kunihiro Matsushita ◽  
Elizabeth Selvin ◽  
Deidra C Crews ◽  
Chiadi E Ndumele ◽  
...  
Keyword(s):  
High School ◽  
Socioeconomic Status ◽  
Natriuretic Peptide ◽  
Low Income ◽  
Statistical Significance ◽  
Cross Sectional Study ◽  
High Risk Population ◽  
Low Ses ◽  
Cross Sectional ◽  
Low Education

Background: The association between socioeconomic status (SES) and clinical cardiovascular disease (CVD) is well established. However, the association between SES and subclinical cardiac overload is unclear. We examined the association of SES with N-terminal pro-B-type natriuretic peptide (NT-pro-BNP), a marker of cardiac overload, in a population without prevalent clinical CVD (coronary disease, stroke, and heart failure hospitalization). Methods: In a cross-sectional study of 11,026 ARIC Study participants without prevalent clinical CVD at visit 2 (1990-1992), we assessed whether education level (<high school (low), high school/equivalent (medium) and >high school (high)) and household income (<$12,000 (low), $12,000 - $24,999 (medium) and ≥ $25,000 (high): $1 in 1991 = ~$1.75 in 2015) were associated with elevated NT-pro-BNP (≥400 pg/ml) in logistic regression models. Given that disproportionately high number of blacks belong to low SES and levels of NT-proBNP might vary by race, we tested SES-race interaction and stratified analyses by race. Results: After accounting for potential confounders, those with low education and income levels demonstrated higher odds of having elevated NT-proBNP compared to those with high education and income, although statistical significance was observed only for income. In race-stratified analysis, association of low education and income with NT-pro-BNP did not appear to differ between blacks and whites (p-interaction with income=0.99 or with education=0.52). When using NT-pro-BNP as a continuous dependent variable, both, low income and education showed a significant association with higher NT-proBNP levels compared to those with high income and education, respectively. Conclusions: Low SES (particularly low income) was associated with elevated level of NT-pro-BNP. Targeting low SES individuals might be helpful in early identification of high risk population for cardiac overload.

scholarly journals Associations of Socioeconomic Status and Physical Activity With Obesity Measures in Rural Chinese Adults

2021 ◽  
Vol 8 ◽  
Author(s):  
Mingming Pan ◽  
Runqi Tu ◽  
Jianjun Gu ◽  
Ruiying Li ◽  
Xiaotian Liu ◽  
...  
Keyword(s):  
Physical Activity ◽  
Clinical Trial ◽  
Socioeconomic Status ◽  
Cohort Study ◽  
Regression Models ◽  
Total Population ◽  
Education Level ◽  
Low Ses ◽  
Men And Women ◽  
Low Education

Background: Although independent association of socioeconomic status (SES) or physical activity (PA) with obesity has been well-documented in urban settings, their independent and joint associations on obesity measures are limited in rural regions.Methods: Almost 38,000 (n = 37,922) individuals were included from the Henan Rural Cohort Study. The International Physical Activity Questionnaire (IPAQ) was used to evaluate PA. Obesity was reflected by body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body fat percentage (BFP), and visceral fat index (VFI). The independent and interactive effects of SES and PA on obesity were analyzed by logistic regression models and generalized linear regression models, respectively.Results: Compared with high education level, the OR (95%CI) of obesity defined by BMI with low education level was 1.466 (1.337, 1.608), 1.064 (0.924, 1.225), and 1.853 (1.625, 2.114) in total population, men and women, respectively. Besides, the OR (95%CI) of obesity defined by BMI associated with per capita monthly income were 1.089 (1.015, 1.170), 1.192 (1.055, 1.347), 1.038 (0.951, 1.133) in total population, men and women, respectively. Similar results had been observed in other obesity measures. Negative interactive association of low education level and PA on obesity measures were observed only in women (all P &lt; 0.05).Conclusions: This study suggests that women are more susceptible to obesity concerning low SES and that adequate PA may be a potential target for mitigating the negative effect of low SES on obesity in women.Clinical Trial Registration: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699) http://www.chictr.org.cn/showproj.aspx?proj=11375.

scholarly journals Possible associations between callers’ degree-of-worry and their socioeconomic status when contacting out-of-hours services: a prospective cohort study

2020 ◽  
Author(s):  
Hejdi Gamst-Jensen ◽  
Sita LeBlanc Thilsted ◽  
Fredrik Folke ◽  
Janne S. Tolstrup ◽  
Lau Caspar Thygesen
Keyword(s):  
Socioeconomic Status ◽  
Patient Safety ◽  
Cohort Study ◽  
Marital Status ◽  
Household Income ◽  
Prospective Cohort ◽  
Low Ses ◽  
Telephone Triage ◽  
Annual Household Income ◽  
Out Of Hours

Abstract Background: Telephone triage within out-of-hours (OOH) services aims to ascertain the urgency of a caller’s medical condition in order to determine the correct type of health care needed, ensuring patient safety. To improve the triage process by increasing patient-centred communication, a triage tool has been developed, whereby callers are asked to rate their degree-of-worry (DOW) as a measure of self-evaluated urgency. Studies show that low socioeconomic status (SES), being single and non-Western ethnicity are associated to low self-rated health and morbidity and these factors may also be associated with high DOW. The aim of this paper was to examine if low SES, being single and non-Western ethnicity were associated to high DOW of callers contacting OOH services. Methods: A prospective cohort study design, at the OOH services for the Capital Region of Denmark. Over two weeks, 6,869 of 38,787 callers met the inclusion criteria: ≥18 years, patients themselves or close relative/friend, reported DOW, had a valid personal identification number and gave informed consent. Callers were asked to report their DOW (1 = minimal worry to 5 = maximal worry), which was dichotomized into low (1–3) and high (4–5) DOW and linked to data from electronical medical records and Statistics Denmark. Socioeconomic factors (education and annual household income), marital status and ethnicity were assessed in relation to DOW by logistic regression. Results: High DOW was reported by 38.2% of the participants. Low SES (low educational level; OR 1.5, 95% CI 1.3–1.7 and low annual household income; 1.5, 1.3–1.6) was associated with high DOW and so too was being single; 1.2, 1.1–1.3 and of non-Western ethnicity; 2.9, 2.5–3.4. Conclusions: Knowledge of the association of low SES, marital status as single and non-Western ethnicity with high DOW among callers to OOH services may give call handlers a better understanding of callers’ DOW. If this does not correspond to the call handler’s perception of urgency, this knowledge may further encourage patient-centred communication, aid the triage process and increase patient safety. A better understanding of socioeconomic variables and their relation to callers’ DOW gives direction for future research to improve telephone triage of OOH services.

scholarly journals Possible associations between callers’ degree-of-worry and their socioeconomic status when contacting out-of-hours services: a prospective cohort study

2020 ◽  
Author(s):  
Hejdi Gamst-Jensen ◽  
Sita LeBlanc Thilsted ◽  
Fredrik Folke ◽  
Janne S. Tolstrup ◽  
Lau Caspar Thygesen
Keyword(s):  
Socioeconomic Status ◽  
Patient Safety ◽  
Cohort Study ◽  
Marital Status ◽  
Household Income ◽  
Prospective Cohort ◽  
Low Ses ◽  
Telephone Triage ◽  
Annual Household Income ◽  
Out Of Hours

Abstract Background:Telephone triage within out-of-hours (OOH) services aims to ascertain the urgency of a caller’s medical condition in order to determine the correct type of health care needed, ensuring patient safety. To improve the triage process by increasing patient‐centred communication, a triage tool has been developed, whereby callers are asked to rate their degree-of-worry (DOW) as a measure of self-evaluated urgency. Studies show that low socioeconomic status (SES), being single and non-Western ethnicity are associated to low self-rated health and morbidity and these factors may also be associated with high DOW. The aim of this paper was to examine if low SES, being single and non-Western ethnicity were associated to high DOW of callers contacting OOH services. Methods: A prospective cohort study design, at the OOH services for the Capital Region of Denmark. Over two weeks, 6,869 of 38,787 callers met the inclusion criteria: ³18 years, patients themselves or close relative/friend, reported DOW, had a valid personal identification number and gave informed consent. Callers were asked to report their DOW (1=minimal worry to 5=maximal worry), which was dichotomized into low (1-3) and high (4-5) DOW and linked to data from electronical medical records and Statistics Denmark. Socioeconomic factors (education and annual household income), marital status and ethnicity were assessed in relation to DOW by logistic regression.Results: High DOW was reported by 38.2% of the participants. Low SES (low educational level; OR 1.5, 95% CI 1.3-1.7 and low annual household income; 1.5, 1.3-1.6) was associated with high DOW and so too was being single; 1.2, 1.1-1.3 and of non-Western ethnicity; 2.9, 2.5-3.4.Conclusions: Knowledge of the association of low SES, marital status as single and non-Western ethnicity with high DOW among callers to OOH services may give call handlers a better understanding of callers’ DOW. If this does not correspond to the call handler’s perception of urgency, this knowledge may further encourage patient-centred communication, aid the triage process and increase patient safety. A better understanding of socioeconomic variables and their relation to callers’ DOW gives direction for future research to improve telephone triage of OOH services.

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