The growing importance of socioeconomic aspects in cardiovascular disease: Results from a cohort study in an Italian nurse registry

Tiziana Federici, Francesco Paneni, Lorenzo Castello, Massimo Volpe

Research output: Contribution to journalArticle

Abstract

Objective: Disparities in mortality between socioeconomic groups have widened during the last decades in Europe, and socioeconomic inequalities in health have been marked as one of the most important issues to be tackled by public health policy. Previous studies have shown an inverse relationship between socioeconomic status (SES) defined by education, income, occupation, social status and neighbourhood environment, and the occurrence of cardiovascular risk factors and disease (CVD). In Italy, poor evidence exists about the relative burden of every single component of SES leading to a higher prevalence of CVD. The aim of this study was to investigate the relationship between SES and CVD in a cohort of patients admitted to our institution over a period of 9 months. Methods: We retrospectively studied 656 patients admitted to our institution over a period of 9 months, performing a correlation between individual SES and the prevalence of CVD. Admissions included day-hospital and ordinary regimens. Occupation was defined by different categories: employed, unemployed, student, housewife, retired/unable, whereas educational level was classified as no qualification, primary school certificate, secondary school certificate, school-leaving certificate, degree or other academic qualifications. A high educational level was defined as school-leaving certificate, degree or other academic certificate, while primary school certificate or no qualification corresponded to a low educational level. Concerning the causes of disease related to admission, we considered all registered diagnoses according to the WHO classification of disease (ICD-9). Results: Educational level and heart disease appeared to be inversely related, showing that people with hypertensive disease and coronary artery disease (CAD) belonged mainly to the low educational group (r = -0.13, p = 0.001). Gender did not alter such findings significantly: the higher the educational level, the lower the prevalence of hypertensive disease and CAD in women (r = -0.17, p = 0.001) and men (r = -0.18, p = 0.001). Occupational status seemed to mainly influence the prevalence of CAD (r = -0.24; p <0.001). In addition, an association between educational level and the choice of admission regimen has been observed (r = -0.27; p <0.001). In the examined population, a more frequent rate of the day-hospital regimen was recorded among high-level qualification subjects compared with ordinary admissions (7.1% vs 6.6%, p <0.001). Conclusions: In this retrospective analysis from an Italian registry, we observed a decrease in the prevalence of CVD with increasing educational status. However, the mechanism underlying this relationship remains uncertain and needs to be addressed in further studies.

Original languageEnglish
Pages (from-to)139-144
Number of pages6
JournalHigh Blood Pressure and Cardiovascular Prevention
Volume14
Issue number3
Publication statusPublished - 2007

Keywords

  • Cardiovascular risk factors
  • Heart disease
  • Socioeconomic status

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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