Trends in educational and income inequalities in cardiovascular morbidity in middle age in Northern Sweden 1993–2010

2018 ◽  
Vol 47 (7) ◽  
pp. 713-721 ◽  
Author(s):  
Anna-Karin Waenerlund ◽  
Paola A. Mosquera ◽  
Per E. Gustafsson ◽  
Miguel San Sebastián
Keyword(s):  
Cardiovascular Disease ◽  
Social Inequalities ◽  
Educational Inequality ◽  
Educational Inequalities ◽  
Northern Sweden ◽  
Middle Aged ◽  
Intervention Programme ◽  
Public Health Perspective ◽  
Cross Sectional ◽  
Income Inequalities

Aims: Research is scarce regarding studies on income and educational inequality trends in cardiovascular disease in Sweden. The aim of this study was to assess trends in educational and income inequalities in first hospitalizations due to cardiovascular disease (CVD) from 1993 to 2010 among middle-aged women and men in Northern Sweden. Methods: The study comprised repeated cross-sectional register data from year 1993–2010 of all individuals aged 38–62 years enrolled in the Västerbotten Intervention Programme (VIP). Data included highest educational level, total earned income and first-time hospitalization for CVD from national registers. The relative and slope indices of inequality (RII and SII, respectively) were used to estimate educational and income inequalities in CVD for six subsamples for women and men, and interaction analyses were used to estimate trends across time periods. Results: Educational RII and SII were stable in women, while they decreased in men. Income inequalities in CVD developed differently compared with educational inequalities, with RII and SII for both men and women increasing during the study period, the most marked for RII in women rising from 1.52 in the 1990s to 2.62 in the late 2000s. Conclusions: The trend of widening income inequalities over 18 years in the middle-aged in Northern Sweden, in the face of stable or even decreasing educational inequalities, is worrisome from a public health perspective, especially as Swedish authorities monitor socioeconomical inequalities exclusively by education. The results show that certain social inequalities in CVD rise and persist even within a traditionally egalitarian welfare regime.

scholarly journals Social inequalities in self-rated health by age: Cross-sectional study of 22 457 middle-aged men and women

2008 ◽  
Vol 8 (1) ◽  
Author(s):  
Emily McFadden ◽  
Robert Luben ◽  
Sheila Bingham ◽  
Nicholas Wareham ◽  
Ann-Louise Kinmonth ◽  
...  
Keyword(s):  
Social Inequalities ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Middle Aged ◽  
Cross Sectional ◽  
Men And Women ◽  
Self Rated Health

scholarly journals Climate impact from diet in relation to background and sociodemographic characteristics in the Västerbotten Intervention Programme

2019 ◽  
Vol 22 (17) ◽  
pp. 3288-3297
Author(s):  
Anna Strid ◽  
Elinor Hallström ◽  
Therese Hjorth ◽  
Ingegerd Johansson ◽  
Bernt Lindahl ◽  
...  
Keyword(s):  
Educational Level ◽  
Urban Areas ◽  
Population Based ◽  
Cross Sectional Study ◽  
Climate Impact ◽  
Sociodemographic Characteristics ◽  
Northern Sweden ◽  
Intervention Programme ◽  
Cross Sectional ◽  
Using Data

AbstractObjective:The objective of this study was to examine climate impact from diet across background and sociodemographic characteristics in a population-based cohort in northern Sweden.Design:A cross-sectional study within the Västerbotten Intervention Programme. Dietary data from a 64-item food frequency questionnaire collected during 1996–2016 were used. Energy-adjusted greenhouse gas emissions (GHGE) for all participants, expressed as kg carbon dioxide equivalents/day and 4184 kJ (1000 kcal), were estimated using data from life cycle analyses. Differences in background and sociodemographic characteristics were examined between participants with low and high GHGE from diet, respectively. The variables evaluated were age, BMI, physical activity, marital status, level of education, smoking, and residence.Setting:Västerbotten county in northern Sweden.Participants:In total, 46 893 women and 45 766 men aged 29–65 years.Results:Differences in GHGE from diet were found across the majority of examined variables. The strongest associations were found between GHGE from diet and age, BMI, education, and residence (all P < 0·001), with the highest GHGE from diet found among women and men who were younger, had a higher BMI, higher educational level, and lived in urban areas.Conclusions:This study is one of the first to examine climate impact from diet across background and sociodemographic characteristics. The results show that climate impact from diet is associated with age, BMI, residence and educational level amongst men and women in Västerbotten, Sweden. These results define potential target populations where public health interventions addressing a move towards more climate-friendly food choices and reduced climate impact from diet could be most effective.

scholarly journals Trends in food intakes in Swedish adults 1986–1999: findings from the Northern Sweden MONICA (Monitoring of Trends and Determinants in Cardiovascular Disease) Study

2005 ◽  
Vol 8 (6) ◽  
pp. 628-635 ◽  
Author(s):  
Benno Krachler ◽  
Mats CE Eliasson ◽  
Ingegerd Johansson ◽  
G/ran Hallmans ◽  
Bernt Lindahl
Keyword(s):  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Body Mass ◽  
Food Frequency Questionnaire ◽  
Linear Trend ◽  
Northern Sweden ◽  
Cross Sectional ◽  
Food Frequency ◽  
Disease Study ◽  
Root Vegetables

AbstractObjectiveTo determine changes in reported food frequency in adults between 1986 and 1999.DesignFour consecutive cross-sectional surveys.SettingCounties of Norrbotten and Västerbotten, Northern Sweden.SubjectsThe Northern Sweden MONICA (Monitoring of Trends and Determinants in Cardiovascular Disease) population, four independent cross-sectional surveys in 1986, 1990, 1994 and 1999. Randomly selected age-stratified samples of the population aged 25–64 years. Analysis is based on 2982 males and 3087 females who completed an 84-item food-frequency questionnaire.ResultsBetween 1986 and 1999, average reported consumption of 3%-fat milk decreased from 42 to 7 intakes month-1 in men and from 28 to 4 intakes month-1 in women. Reported use of 1.5%-fat milk increased from 6 to 27 intakes month-1 in men and from 6 to 24 in women. Monthly intakes of potatoes and root vegetables decreased from 38 to 27 in men and from 39 to 32 in women. Consumption of pasta increased from 4 to 7 intakes month-1 in both sexes. Intakes of solid fats with 80% fat content dropped from 92 to 62 per month in men and from 78 to 52 per month in women, whereas use of 40%-fat spread increased from 12 to 22 intakes month-1 in men and from 5 to 26 in women. Monthly intakes of vegetable oil increased from 3 to 12 in men and from 3 to 15 in women. The percentage of overweight or obese individuals (body mass index >25 kg m-2) increased from 52 to 65% in men and from 41 to 52% in women (P for linear trend in all these changes, <0.001).ConclusionsOur data indicate reduced consumption of foods with a high content of saturated fats. In spite of that, there is an unbroken trend towards increased obesity.

scholarly journals Comorbid cardiovascular disease and major depression among ethnic and racial groups in the United States

2013 ◽  
Vol 25 (5) ◽  
pp. 833-841 ◽  
Author(s):  
Hector M. González ◽  
Wassim Tarraf
Keyword(s):  
United States ◽  
Cardiovascular Disease ◽  
Major Depression ◽  
Disease Burden ◽  
The United States ◽  
Racial Groups ◽  
Middle Aged ◽  
Cross Sectional ◽  
Race Ethnicity ◽  
National Probability Sample

ABSTRACTBackground: To describe and examine the distribution, disability, and treatment associated with comorbid cardiovascular disease and major depressive disorder (CVD/MDD) among middle-aged and older ethnic/racial groups in the United States.Methods: Cross-sectional data from a national probability sample of household resident adults (18 years and older; N = 16,423) living in the 48 coterminous United States were analyzed. We defined comorbid CVD/MDD as the presence of CVD (e.g. diabetes, hypertension, heart disease, and stroke) among adults who met MDD criteria at or after age 50 years.Results: Two-thirds of middle-aged and older American adults meeting criteria major depression at or after age 50 years also reported a diagnosis of comorbid CVD. Blacks were most likely to meet our comorbid CVD/MDD (74.4%) criteria. The disease burden of depression was also highest among Black respondents. Differences in treatment due to race/ethnicity and comorbidity were not statistically significant.Conclusions: Our findings indicate that among middle-aged and older US adults meeting MDD criteria more than half would also report a comorbid CVD. Comorbid CVD/MDD rates varied between the considered ethnic/race groups. Functional impairment associated with comorbid CVD/MDD was higher than MDD alone; however, depression care rates did not differ remarkably. Among middle-aged and older adults meeting MDD criteria, comorbid CVD may be the rule rather than the exception.

scholarly journals Socioeconomic inequalities in physical activity in Brazil: a pooled cross-sectional analysis from 2013 to 2019

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Gerson Ferrari ◽  
Pedro Toteff Dulgheroff ◽  
Rafael M. Claro ◽  
Leandro F. M. Rezende ◽  
Catarina Machado Azeredo
Keyword(s):  
Physical Activity ◽  
Leisure Time ◽  
Leisure Time Physical Activity ◽  
Educational Inequality ◽  
Socioeconomic Inequalities ◽  
Total Physical Activity ◽  
Active Commuting ◽  
Educational Inequalities ◽  
Cross Sectional ◽  
Over Time

Abstract Background Information on socioeconomic inequalities in physical activity over time is sparse in low- to middle-income countries. In this study, we examined trends in physical activity educational inequalities in adults from Brazil between 2013 and 2019. Methods We analyzed data from seven cross-sectional studies including 359,038 adults (≥ 18 years) from the VIGITEL study conducted annually from 2013 to 2019. Participants responded to a questionnaire about physical activity (total, leisure, and commuting). Educational inequalities by sex and skin color were assessed through absolute (slope index of inequality – SII) and relative measures of inequality (concentration index – CIX). Results We found large absolute and relative inequalities for leisure-time physical activity, favoring those with higher educational attainment (SII2019 = 35.4; CIX2019 = 11.82). Active commuting was more prevalent in intermediate education groups, with a slight inequality toward the less educated group (SII2019 = -2.8; CIX2019 = -0.4). From 2013 to 2019, the absolute educational inequality in physical activity (total, leisure, and commuting) remained unchanged; however, the relative inequality gap narrowed for total physical activity (CIX: 8.4 in 2013 to 5.5 in 2019) and leisure-time physical activity (CIX: 18.3 in 2013 to 11.8 in 2019). Educational inequality increased in leisure-time physical activity among women and non-white individuals, while it reduced among men and white individuals; for active commuting, inequality decreased among women, and increased among men and white individuals. Conclusions Inequality in total physical activity and leisure-time physical activity favors the most educated groups in Brazil. Over time, relative educational inequality decreased for total and leisure-time physical activity, while no progress was found for absolute inequality.

scholarly journals Prevalence and determinants of hypertension control among almost 100 000 treated adults in the UK

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001461
Author(s):  
Neo Tapela ◽  
Jennifer Collister ◽  
Lei Clifton ◽  
Iain Turnbull ◽  
Kazem Rahimi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Population Based ◽  
Lower Probability ◽  
Normal Body Mass Index ◽  
Hypertension Control ◽  
Middle Aged ◽  
Higher Alcohol ◽  
Cross Sectional ◽  
The Uk

ObjectiveTo identify factors associated with hypertension control among treated middle-aged UK adults.MethodsA cross-sectional population-based study including 99 468 previously diagnosed, treated hypertensives enrolled in the UK Biobank. Hypertension control was defined as systolic blood pressure <140 mm Hg and diastolic blood pressure <90 mm Hg.ResultsMedian age was 62.3 years (IQR 57.3 to 66.0), 45.9% female, 92.0% white, 40.1% obese, 9.3% current smokers and 19.4% had prior cardiovascular disease. 38.1% (95% CI 37.8% to 38.4%) were controlled. In multivariable logistic regression, associations with lack of hypertension control included: older age (OR 0.61, 95% CI 0.58 to 0.64 for 60–69 years compared with age 40–50 years), higher alcohol use (OR 0.61, 95% CI 0.58 to 0.64, for consuming >30 units per week compared with none), black ethnicity (OR 0.73, 95% CI 0.65 to 0.82 compared with white), obesity (OR 0.73, 95% CI 0.71 to 0.76 compared with normal body mass index). The strongest positive association with control was having ≥3 comorbidities (OR 2.09, 95% CI 1.95 to 2.23). Comorbidities associated with control included cardiovascular disease (OR 2.11, 95% CI 2.04 to 2.19), migraines (OR 1.68, 95% CI 1.56 to 1.81), diabetes (OR 1.32, 95% CI 1.27 to 1.36) and depression (OR 1.27, 95% CI 1.20 to 1.34).ConclusionsIn one of the largest population-based analyses of middle-aged adults with measured blood pressure, the majority of treated hypertensives were uncontrolled. Risk factors for hypertension were associated with a lower probability of control. Having a comorbidity was associated with higher probability of control, possibly due to more frequent interaction with the healthcare system and/or appropriate management of those at greater cardiovascular risk.

Minerals Intake Distributions in a Large Sample of Iranian at-Risk Population Using the National Cancer Institute Method: Do They Meet Their Requirements?

2015 ◽  
Vol 85 (3-4) ◽  
pp. 129-144 ◽  
Author(s):  
Zahra Heidari ◽  
Awat Feizi ◽  
Leila Azadbakht ◽  
Nizal Sarrafzadegan
Keyword(s):  
At Risk ◽  
National Cancer Institute ◽  
Population Based ◽  
Cross Sectional Study ◽  
Normal Function ◽  
Dietary Intakes ◽  
Middle Aged ◽  
Cross Sectional ◽  
Nutritional Interventions ◽  
High Prevalence

Abstract. Background: Minerals are required for the body’s normal function. Aim: The current study assessed the intake distribution of minerals and estimated the prevalence of inadequacy and excess among a representative sample of healthy middle aged and elderly Iranian people. Methods: In this cross-sectional study, the second follow up to the Isfahan Cohort Study (ICS), 1922 generally healthy people aged 40 and older were investigated. Dietary intakes were collected using 24 hour recalls and two or more consecutive food records. Distribution of minerals intake was estimated using traditional (averaging dietary intake days) and National Cancer Institute (NCI) methods, and the results obtained from the two methods, were compared. The prevalence of minerals intake inadequacy or excess was estimated using the estimated average requirement (EAR) cut-point method, the probability approach and the tolerable upper intake levels (UL). Results: There were remarkable differences between values obtained using traditional and NCI methods, particularly in the lower and upper percentiles of the estimated intake distributions. A high prevalence of inadequacy of magnesium (50 - 100 %), calcium (21 - 93 %) and zinc (30 - 55 % for males > 50 years) was observed. Significant gender differences were found regarding inadequate intakes of calcium (21 - 76 % for males vs. 45 - 93 % for females), magnesium (92 % vs. 100 %), iron (0 vs. 15 % for age group 40 - 50 years) and zinc (29 - 55 % vs. 0 %) (all; p < 0.05). Conclusion: Severely imbalanced intakes of magnesium, calcium and zinc were observed among the middle-aged and elderly Iranian population. Nutritional interventions and population-based education to improve healthy diets among the studied population at risk are needed.

Relative risk of cardiovascular disease is higher in women with type 2 diabetes, but not in those with prediabetes, as compared with men

2020 ◽  
Author(s):  
Elena Succurro ◽  
Teresa Vanessa Fiorentino ◽  
Sofia Miceli ◽  
Maria Perticone ◽  
Angela Sciacqua ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Longitudinal Study ◽  
Relative Risk ◽  
Hdl Cholesterol ◽  
Cross Sectional Study ◽  
Adverse Outcomes ◽  
Cross Sectional ◽  
Normal Glucose

<b>Objective</b>: Most, but not all studies suggested that women with type 2 diabetes have higher relative risk (RR) for cardiovascular disease (CVD) than men. More uncertainty exists on whether the RR for CVD is higher in prediabetic women compared to men. <p><b>Research Design and Methods</b>: In a cross-sectional study, in 3540 normal glucose tolerant (NGT), prediabetic, and diabetic adults, we compared the RR for prevalent non-fatal CVD between men and women. In a longitudinal study including 1658 NGT, prediabetic, and diabetic adults, we compared the RR for incident major adverse outcomes, including all-cause death, coronary heart disease, and cerebrovascular disease events after 5.6 years follow-up. </p> <p><b>Results:</b> Women with prediabetes and diabetes exhibited greater relative differences in BMI, waist circumference, blood pressure, total, LDL and HDL cholesterol, triglycerides, fasting glucose, hsCRP, and white blood cell count than men with prediabetes and diabetes when compared with their NGT counterparts. We found a higher RR for prevalent CVD in diabetic women (RR 9.29; 95% CI 4.73-18.25; <i>P</i><0.0001) than in men (RR 4.56; 95% CI 3.07-6.77; <i>P</i><0.0001), but no difference in RR for CVD was observed comparing prediabetic women and men. In the longitudinal study, we found that diabetic, but not prediabetic women have higher RR (RR 5.25; 95% CI 3.22-8.56; <i>P</i><0.0001) of incident major adverse outcomes than their male counterparts (RR 2.72; 95% CI 1.81-4.08; <i>P</i><0.0001).</p> <p><b>Conclusions:</b> This study suggests that diabetic, but not prediabetic, women have higher RR for prevalent and incident major adverse outcomes than men. </p>

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