Trends in socioeconomic disparities in stroke mortality in six European countries between 1981-1985 and 1991-1995
Trends in socioeconomic disparities in stroke mortality in six European countries between 1981-1985 and 1991-1995
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DOI：
10.1093/aje/kwi011
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发表时间：
2005-01-01
影响因子：
5
通讯作者：
Mackenbach, JP
中科院分区：
文献类型：
--
作者：
Avendaño, M;Kunst, AE;Mackenbach, JP
这项研究评估了社会经济地位较低的人群中卒中死亡率趋势是否不如较高的人群有利。获得了芬兰、挪威、丹麦、瑞典、英格兰/威尔士和意大利的都灵的社会经济状况死亡率纵向数据。数据涵盖整个人口或代表性样本。计算了1981-1995年期间的中风死亡率。采用Poisson回归分析卒中死亡率比值的变化，并与缺血性热病死亡率比值进行比较。卒中死亡率的趋势在较低和较高社会经济群体中普遍有利，因此卒中死亡率的社会经济差异持续存在，并且在20世纪90年代与20世纪80年代保持相似的幅度。然而，在挪威，中风死亡率的职业差异显着扩大，而在一些国家则观察到无显着增加。相反，在这一时期，大多数人群中缺血性心脏病死亡率的差异扩大了。在大多数国家，高血压患病率和治疗的改善可能有助于所有社会经济群体中类似的卒中死亡率下降。中风死亡率的社会经济差异通常持续存在，并且在某些人群中可能有所扩大，这一事实凸显了改善低社会经济群体中风预防和二级护理的必要性。
This study assesses whether stroke mortality trends have been less favorable among lower than among higher socioeconomic groups. Longitudinal data on mortality by socioeconomic status were obtained for Finland, Norway, Denmark, Sweden, England/Wales, and Turin, Italy. Data covered the entire population or a representative sample. Stroke mortality rates were calculated for the period 1981-1995. Changes in stroke mortality rate ratios were analyzed using Poisson regression and compared with rate ratios in ischemic heat disease mortality. Trends in stroke mortality were generally as favorable among lower as among higher socioeconomic groups, such that socioeconomic disparities in stroke mortality persisted and remained of a similar magnitude in the 1990s as in the 1980s. In Norway, however, occupational disparities in stroke mortality significantly widened, and a nonsignificant increase was observed in some countries. In contrast, disparities in ischemic heart disease mortality widened throughout this period in most populations. Improvements in hypertension prevalence and treatment may have contributed to similar stroke mortality declines in all socioeconomic groups in most countries. Socioeconomic disparities in stroke mortality generally persisted and may have widened in some populations, which fact underlines the need to improve preventive and secondary care for stroke among the lower socioeconomic groups.