Relationship of Socioeconomic Status to the Incidence and Prehospital, 28-Day, and 1-Year Mortality Rates of Acute Coronary Events in the FINMONICA Myocardial Infarction Register Study
- 25 April 2000
- journal article
- other
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 101 (16), 1913-1918
- https://doi.org/10.1161/01.cir.101.16.1913
Abstract
Background —Low socioeconomic status (SES) is associated with increased coronary heart disease mortality rates. There are, however, very little data on the relation of SES to the incidence, recurrence, and prognosis of myocardial infarction (MI) events. Methods and Results —The FINMONICA MI Register recorded detailed information on all MI events among men and women aged 35 to 64 years in 3 areas of Finland during the period of 1983 to 1992. We carried out a record linkage of the MI register data with files of Statistics Finland to obtain information on indicators of SES, such as taxable income and education, for each individual who is registered. In the analyses, income was grouped into 3 categories (low, middle, and high), and education was grouped into 2 categories (basic and secondary or higher). Among men with their first MI event (n=6485), the adjusted incidence rate ratios were 1.67 (95% CI 1.57 to 1.78) and 1.84 (95% CI 1.73 to 1.95) in the low- and middle-income categories compared with the high-income category. For 28-day mortality rates, the corresponding rate ratios were 3.18 (95% CI 2.82 to 3.58) and 2.33 (95% CI 2.03 to 2.68). Significant differentials were observed for prehospital mortality rates, and they remained similar up to 1 year after the MI. Findings among the women were consistent with those among the men. Conclusions —The excess coronary heart disease mortality and morbidity rates among persons with low SES are considerable in Finland. To bring the mortality rates of low- and middle-SES groups down to the level of that of the high-SES group constitutes a major public health challenge.Keywords
This publication has 21 references indexed in Scilit:
- Effects of Socioeconomic Status on Access to Invasive Cardiac Procedures and on Mortality after Acute Myocardial InfarctionNew England Journal of Medicine, 1999
- Contribution of trends in survival and coronar y-event rates to changes in coronary heart disease mortality: 10-year results from 37 WHO MONICA Project populationsThe Lancet, 1999
- Do changes in cardiovascular risk factors explain the increasing socioeconomic difference in mortality from ischaemic heart disease in Finland?Journal of Epidemiology and Community Health, 1998
- Socioeconomic differences in risk of myocardial infarction 1971-1994 in Sweden: time trends, relative risks and population attributable risksInternational Journal of Epidemiology, 1998
- Socioeconomic differentials in mortality risk among men screened for the Multiple Risk Factor Intervention Trial: I. White men.American Journal of Public Health, 1996
- Socioeconomic Inequalities in Coronary Heart Disease and Stroke Mortality among Australian Men, 1979–1993International Journal of Epidemiology, 1996
- Diagnosis of acute myocardial infarction by Monica and Finmonica diagnostic criteria in comparison with hospital discharge diagnosisJournal of Clinical Epidemiology, 1994
- Problems in the measurement and international comparison of socio-economic differences in mortalitySocial Science & Medicine, 1993
- Magnitude and causes of socioeconomic differentials in mortality: further evidence from the Whitehall Study.Journal of Epidemiology and Community Health, 1990
- Social class and coronary heart disease.Heart, 1981