Socioeconomic Indicators and the Risk of Acute Coronary Heart Disease Events: Comparison of Population-Based Data from the United States and Finland

• Published in: Annals of epidemiology Vol. 21; no. 8; pp. 572 - 579
• Main Authors: Kucharska-Newton, Anna M., PhD, MPH, Harald, Kennet, MA, Rosamond, Wayne D., PhD, Rose, Kathryn M., PhD, Rea, Thomas D., MD, MPH, Salomaa, Veikko, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2011
• Subjects: Adult; Alcohol; Cardiovascular diseases; Cohort Studies; Coronary Disease - economics; Coronary Disease - epidemiology; Death; Death, Sudden, Cardiac - epidemiology; Education; Female; Finland - epidemiology; Humans; income; Internal Medicine; Male; Middle Aged; Mortality; myocardial infarction; Myocardial Infarction - economics; Myocardial Infarction - epidemiology; Non-Fatal MI; Poverty - statistics & numerical data; Risk Factors; Smoking; Social Class; Socioeconomic Factors; Socioeconomics; Sudden Cardiac Death; United States - epidemiology; United States; Finland; USA; Atherosclerosis Risk in Communities; SES; International Classification of Diseases; NSCD; body mass index; myocardial infarction; Sudden Cardiac Death; ICD; non-sudden cardiac death; Socioeconomic Factors; NFMI; Non-Fatal MI; ARIC; non-fatal myocardial infarction; SCD; coronary heart disease; MI; socioeconomic status; CHD; Cohort Studies; BMI
• ISSN: 1047-2797; 1873-2585
• DOI: 10.1016/j.annepidem.2011.04.006

Purpose We wished to determine whether a gradient of association of low socioeconomic status with incidence of coronary heart disease was present in two population-based cohorts, one from United States and the other from Finland. Methods Using data from the Atherosclerosis Risk in Communities (ARIC) cohort and the Finnish FINRISK cohort, we estimated, with Cox proportional hazard regression models, incidence of sudden cardiac death (SCD), non-sudden cardiac death (NSCD), and non-fatal myocardial infarction (NFMI) for strata of income and education (follow-up: 1987–2001). In both cohorts, incidence rates of the three outcomes increased across all socioeconomic status exposure categories. Results Low education was associated with increased hazard of NFMI in both cohorts and with increased risk of SCD among ARIC women. Low income was significantly associated with increased hazard of all three outcomes among ARIC women and with increased hazard of cardiac death among ARIC men. In FINRISK, low income was significantly associated with increased risk of SCD only. Risk of SCD in the low income categories was similar for both cohorts. Smoking, alcohol consumption, and race (ARIC only) did not appreciably alter effect estimates in either cohort. Conclusions Indices of low SES show similar associations with increased risk of cardiac events in Finland and in United States.