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Journal of General Internal Medicine

Erschienen in:

01.10.2008 | Original Article

Socioeconomic Position and Cardiovascular Disease in Adults with and Without Diabetes: United States Trends, 1997–2005

verfasst von: Rosemary Dray-Spira, MD, PhD, Tiffany L. Gary, PhD, MHS, Frederick L. Brancati, MD, MHS

Erschienen in: Journal of General Internal Medicine | Ausgabe 10/2008

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Abstract

Background

Diabetes and its cardiovascular complications are more common in adults of low socioeconomic position (SEP). In the US, the past decade has seen the establishment of many programs to reduce cardiovascular risk in persons with diabetes, but their effect on socioeconomic disparities is uncertain.

Objective

We sought to investigate recent time trends in socioeconomic disparities in cardiovascular disease (CVD) among persons with and without diabetes.

Participants and Design

Two hundred fifty-five thousand nine hundred sixty-six individuals aged 25 years or older included in the National Health Interview Survey between 1997 and 2005.

Measurements

Educational attainment was used as a marker for SEP and self-reported history of CVD as the main outcome. Educational disparities were measured using prevalence rate ratios (PRR) and the relative index of inequalities (RII).

Main Results

Among adults with diabetes, CVD prevalence was persistently higher in those who did not complete high school (HS) than in college graduates (adjusted PRR [aPRR] 1.20, 95% confidence interval [95%CI] 1.05–1.38 in 1997–1999, and aPRR 1.12, 95% CI 1.00–1.25 in 2003–2005). However, the HS vs. college graduates disparity in CVD declined from 1997–1999 (aPRR 1.20, 95% CI 1.04–1.37) to 2003–2005 (aPRR 1.01, 95% CI 0.90–1.12). Among adults without diabetes educational disparities in CVD widened markedly over time.

Conclusions

Concurrently with improvements in diabetes management, the widening of socioeconomic health disparities has remained limited in the diabetic population during the past decade. This provides evidence for the potential impact of improvements in disparities in health care access and process, such as experienced among persons with diabetes, in limiting socioeconomic health disparities.

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Titel: Socioeconomic Position and Cardiovascular Disease in Adults with and Without Diabetes: United States Trends, 1997–2005
verfasst von: Rosemary Dray-Spira, MD, PhD
Tiffany L. Gary, PhD, MHS
Frederick L. Brancati, MD, MHS
Publikationsdatum: 01.10.2008
Verlag: Springer-Verlag
Erschienen in: Journal of General Internal Medicine / Ausgabe 10/2008
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-008-0727-5

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Socioeconomic Position and Cardiovascular Disease in Adults with and Without Diabetes: United States Trends, 1997–2005

Abstract

Background

Objective

Participants and Design

Measurements

Main Results

Conclusions

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Abstract

Background

Objective

Participants and Design

Measurements

Main Results

Conclusions

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