Socioeconomic gradients in the prevalence of cardiovascular disease in Scotland: the roles of composition and context
Socioeconomic gradients in the prevalence of cardiovascular disease in Scotland: the roles of composition and context
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DOI：
10.1136/jech.2005.034017
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发表时间：
2005-09-01
影响因子：
6.3
通讯作者：
Leyland, AH
中科院分区：
文献类型：
--
作者：
Leyland, AH
目的：调查调整吸烟状况后，职业社会阶层和地区剥夺是否与心血管疾病（CVD）患病率独立相关。设计：使用多水平逻辑回归分析分层多阶段随机样本。参与者：1998 - 1999 年采访时年龄为 18 - 74 岁的 8804 名成年人，聚集在 312 个小区域。考虑的结果是医生对多种心血管疾病之一的诊断的自我报告。该调查还提供了有关受访者的职业社会阶层和当前吸烟状况的信息。 Carstairs 评分（基于 1991 年人口普查）用于描述小面积剥夺。主要结果：当考虑面积剥夺时，各个社会阶层的 CVD 患病率梯度减弱并变得微不足道。个人社会阶层和吸烟在地区水平上的聚集增加了与个人水平疾病患病率的相关性。结论：尽管苏格兰的社会经济地位与CVD患病率之间存在相关性，但这种关系主要以地区剥夺为主。当外部验证的剥夺措施不可用时，汇总的个人特征可能会显示出上下文（与组合相比）关系。
Objective: To investigate whether occupational social class and area deprivation are independently associated with the prevalence of cardiovascular disease (CVD) conditions after adjustment for smoking status.Design: Stratified multistage random sample analysed using multilevel logistic regression.Participants: 8804 adults aged 18 - 74 at time of interview in 1998 - 1999, clustered in 312 small areas. The outcome considered was a self report of doctor diagnosis of one of a number of CVD conditions. The survey also provided information concerning the respondent's occupational social class and current smoking status. The Carstairs score ( based on the 1991 census) was used to describe small area deprivation.Main results: The gradient in CVD prevalence across individual social class was attenuated and became insignificant when area deprivation was considered. The aggregation of individual social class and smoking to the area level increased the correlation with disease prevalence at the individual level.Conclusions: Although there is a relation between socioeconomic status and CVD prevalence in Scotland, the relation is dominated by area deprivation. When externally validated deprivation measures are not available, aggregated individual characteristics may show a contextual ( as compared with compositional) relation.