Life chances after surgery of congenital heart disease: the influence of cardiac surgery on intergenerational social mobility. A comparison between patients and general population data

Abstract

Background To examine whether operated congenital heart disease (CHD) is setting preconditions for an active life by comparing intergenerational social mobility in patients with a population sample. Design and methods The patient sample consisted of 314 females (42.1%) and males who underwent surgery for CHD (mean age at surgery 7.3 years, SD 7.8). According to the type of surgery, patients were classified as curative, reparative, or palliative. Consequently, the three groups reflect increasing severities of the initial heart defect. The mean age at examination was 26.9 years (7.6). Controls consisted of individuals who participated in the 2002 survey of the German Socio-Economic Panel. All individuals with complete sociodemographic information were included, and the final sample consisted of 4864 women (46.1%) and men (mean age 32.5 years, SD 7.2). Results Once having entered the labour market, intergenerational social mobility between patients and controls did not differ. For upward mobility respondents’ social background was the key determinant; the respective standardized regression effect was β = 0.66. After dividing the study population, the social background turned out to having a slightly stronger effect in patients (β = 0.73) than in controls (β = 0.65). For downward mobility effects of the social background were smaller than for upward mobility (β = 0.19 in patients and β = 0.21 in controls). In economically active patients CHD severity did not determine social mobility. Discussion We conclude that a large proportion of patients could not or did not enter the labour market. Those who did experienced social mobility rates that are comparable with the general population. Eur J Cardiovasc Prev Rehabil 14: 128-134 © 2007 The European Society of Cardiology