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Income-related inequalities in cardiovascular disease from mid-life to old age in a Northern Swedish cohort : a decomposition analysis
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- Mosquera, Paola A, 1979- (author)
- Umeå universitet,Epidemiologi och global hälsa,Umeå SIMSAM Lab
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- San Sebastian, Miguel, 1966- (author)
- Umeå universitet,Epidemiologi och global hälsa
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- Waenerlund, Anna-Karin, 1982- (author)
- Umeå universitet,Epidemiologi och global hälsa
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- Elsevier, 2016
- 2016
- English.
- In: Social Science and Medicine. - : Elsevier. - 0277-9536 .- 1873-5347. ; 149, s. 135-144
- Journal article (peer-reviewed)
Abstract
Subject headings
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- While the social determinants of cardiovascular disease (CVD) are fairly well-known, the determinants of socioeconomic inequalities in CVD are scarcely studied and almost completely based on cross-sectional designs in which the changing circumstances across the life course are not taken into account. The present study seeks to incorporate a life course approach to the social determinants of socioeconomic inequalities in CVD. The specific aims were to 1) examine how income-related inequalities in CVD change over two decades of the mid-late life course, and 2) identify the key social determinants of the inequalities at each time period. The cohort (N = 44,039) comprised all individuals aged 40-60 years in 1990 who during 1990-2010 were enrolled in the county-wide preventive effort :"Västerbotten Intervention Program" (VIP). The cohort was followed over these two decades by Swedish population register data linked within the Umeå SIMSAM Lab micro data infrastructure. First-time hospitalization for CVD and mean earned income were used to calculate the concentration index (C) during four periods of 5-6 years. The C for each period was decomposed by sociodemographic factors, using Wagstaff-type decomposition analysis. Results suggest that inequalities in CVD increase gradually from mid-life to old age; from initially non-significant to particularly marked among the elderly. The decomposition showed that, from middle to old age, educational and employment inequalities underwent a transition from initially dominant to a moderate role in explaining the health inequalities, coupled with an increasing importance of age and a stable role of income. In conclusion, the study illustrates the need for incorporating a dynamic life course perspective into research, policy and practice concerned with equity in health.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
Keyword
- Cardiovascular disease
- Income inequality
- Concentration index
- Decomposition. Life course
- Cohort design
- Sweden
Publication and Content Type
- ref (subject category)
- art (subject category)
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