This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Are Socioeconomic Differences Widening?

Carlos Iribarren, MD, MPH, PhD; Russell V. Luepker, MD; Paul G. McGovern, PhD; Donna K. Arnett, PhD; Henry Blackburn, MD

Arch Intern Med. 1997;157(8):873-881.

Abstract
Background
Inverse associations of educational level and household income (as proxy indicators of socioeconomic status)with cardiovascular disease risk factors are fairly well established. Whether differences in cardiovascular disease risk factors across education or income levels have widened in the last decade remains an issue of considerable public health importance.

Methods
Analysis by mixed-regression models of trends in cardiovascular disease risk factors, in population-based samples (n=3334 in 1980-1982, n=4538 in 1985-1987, and n=4517 in 1990-1992) of Minneapolis—St Paul residents 25 to 74 years old.

Results
Education level was inversely related to serum cholesterol level, systolic blood pressure, smoking prevalence, and body mass index and positively related to leisure-time physical activity and health knowledge in both sexes. Household income was inversely associated with systolic blood pressure and body mass index in women and with smoking prevalence in both sexes. Income level was positively associated with leisure-time physical activity and health knowledge in both sexes.

There were overall favorable downward secular trends in serum cholesterol level and systolic blood pressure, favorable upward trends in health knowledge, and unfavorable upward trends in body mass index across all socioeconomic status groups. Throughout the decade, trends in smoking prevalence differed by education level in men (P=.01), such that declines were observed only in those with a college degree or some college education. With respect to trends in leisure-time physical activity, there were greater gains among men with low socioeconomic status (P=.03 for education; P=.02 for income) and among less affluent women (P=.001).

Conclusions
These data support the inverse association between socioeconomic status and cardiovascular disease risk factors but suggest no widening (with the exception of smoking by education level in men) of socioeconomic differences in risk factor trends during the last decade in a representative sample of the Minneapolis—St Paul population.

Arch Intern Med. 1997;157:873-881

Author Affiliations
From the Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Prehypertension during Young Adulthood and Coronary Calcium Later in Life
Pletcher et al.
ANN INTERN MED 2008;149:91-99.
ABSTRACT | FULL TEXT  

Educational attainment and cigarette smoking: a causal association?
Gilman et al.
Int J Epidemiol 2008;37:615-624.
ABSTRACT | FULL TEXT  

Physical Activity Influences in a Disadvantaged African American Community and the Communities' Proposed Solutions
Griffin et al.
Health Promot Pract 2008;9:180-190.
ABSTRACT  

The Relative Strength of C-Reactive Protein and Lipid Levels as Determinants of Ischemic Stroke Compared With Coronary Heart Disease in Women
Everett et al.
J Am Coll Cardiol 2006;48:2235-2242.
ABSTRACT | FULL TEXT  

Socioeconomic Status and Trends in Disparities in 4 Major Risk Factors for Cardiovascular Disease Among US Adults, 1971-2002
Kanjilal et al.
Arch Intern Med 2006;166:2348-2355.
ABSTRACT | FULL TEXT  

Education, 15-year risk factor progression, and coronary artery calcium in young adulthood and early middle age: the Coronary Artery Risk Development in Young Adults study.
Yan et al.
JAMA 2006;295:1793-1800.
ABSTRACT | FULL TEXT  

Trends in smoking behaviour between 1985 and 2000 in nine European countries by education
Giskes et al.
J. Epidemiol. Community Health 2005;59:395-401.
ABSTRACT | FULL TEXT  

Cardiovascular Risk Factors in Iranian Adults according to Educational Levels: Isfahan Healthy Heart Program
Roohafza et al.
Asia Pac J Public Health 2005;17:9-14.
ABSTRACT  

Hormone Replacement Therapy and Cardiovascular Disease: What Went Wrong and Where Do We Go From Here?
Dubey et al.
Hypertension 2004;44:789-795.
ABSTRACT | FULL TEXT  

Predictors and Tracking of Body Mass Index From Adolescence Into Adulthood: Follow-up of 18 to 20 Years in the Oslo Youth Study
Kvaavik et al.
Arch Pediatr Adolesc Med 2003;157:1212-1218.
ABSTRACT | FULL TEXT  

An Epidemiologist Looks at Hormones and Heart Disease in Women
Barrett-Connor
J. Clin. Endocrinol. Metab. 2003;88:4031-4042.
FULL TEXT  

Trends in Risk Factors for Lifestyle-Related Diseases by Socioeconomic Position in Geneva, Switzerland, 1993-2000: Health Inequalities Persist
Galobardes et al.
AJPH 2003;93:1302-1309.
ABSTRACT | FULL TEXT  

Associations between unemployment and cardiovascular risk factors varies with the unemployment rate: The Cardiovascular Risk Factor Study in Southern Sweden (CRISS)
Henriksson et al.
Scand J Public Health 2003;31:305-311.
ABSTRACT  

Participation in Recreational Physical Activity: Why Do Socioeconomic Groups Differ?
Burton et al.
Health Educ Behav 2003;30:225-244.
ABSTRACT  

A Controlled Trial of Web-Based Diabetes Disease Management: The MGH Diabetes Primary Care Improvement Project
Meigs et al.
Diabetes Care 2003;26:750-757.
ABSTRACT | FULL TEXT  

Area Characteristics, Individual-Level Socioeconomic Indicators, and Smoking in Young Adults: The Coronary Artery Disease Risk Development in Young Adults Study
Diez Roux et al.
Am J Epidemiol 2003;157:315-326.
ABSTRACT | FULL TEXT  

Change in health inequalities among British civil servants: the Whitehall II study
Ferrie et al.
J. Epidemiol. Community Health 2002;56:922-926.
ABSTRACT | FULL TEXT  

Health Opportunities with Physical Exercise (HOPE): social contextual interventions to reduce sedentary behavior in urban settings
Coday et al.
Health Educ Res 2002;17:637-647.
ABSTRACT | FULL TEXT  

Time trends of major coronary risk factors in a northern Italian population (1986-1994). How remarkable are socioeconomic differences in an industrialized low CHD incidence country?
Ferrario et al.
Int J Epidemiol 2001;30:285-297.
ABSTRACT | FULL TEXT  

Social distribution of cardiovascular disease risk factors: change among men in England 1984-1993
Bartley et al.
J. Epidemiol. Community Health 2000;54:806-814.
ABSTRACT | FULL TEXT  

Changes in cardiovascular risk factors in different socioeconomic groups: seven year trends in a Chinese urban population
Yu et al.
J. Epidemiol. Community Health 2000;54:692-696.
ABSTRACT | FULL TEXT  

Calcification of the Aortic Arch: Risk Factors and Association With Coronary Heart Disease, Stroke, and Peripheral Vascular Disease
Iribarren et al.
JAMA 2000;283:2810-2815.
ABSTRACT | FULL TEXT  

Social inequalities in health related behaviours in Barcelona
Borrell et al.
J. Epidemiol. Community Health 2000;54:24-30.
ABSTRACT | FULL TEXT