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Contribution of inc...
Contribution of income and job strain to the association between education and cardiovascular disease in 1.6 million Danish employees
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Framke, Elisabeth (author)
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Sørensen, Jeppe Karl (author)
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Andersen, Per Kragh (author)
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Svane-Petersen, Annemette Coop (author)
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- Alexanderson, Kristina (author)
- Karolinska Institutet
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Bonde, Jens Peter (author)
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- Farrants, Kristin (author)
- Karolinska Institutet
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Meulengracht Flachs, Esben (author)
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- Magnusson Hanson, Linda L (author)
- Stockholms universitet,Stressforskningsinstitutet
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Nyberg, Solja T (author)
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Villadsen, Ebbe (author)
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Kivimäki, Mika (author)
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Rugulies, Reiner (author)
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Madsen, Ida E H (author)
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(creator_code:org_t)
- 2019-12-17
- 2020
- English.
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In: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 41:11, s. 1164-1178
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https://doi.org/10.1...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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Abstract
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- Aims: We examined the extent to which associations between education and cardiovascular disease (CVD) morbidity and mortality are attributable to income and work stress.Methods and results: We included all employed Danish residents aged 30–59 years in 2000. Cardiovascular disease morbidity analyses included 1 638 270 individuals, free of cardiometabolic disease (CVD or diabetes). Mortality analyses included 41 944 individuals with cardiometabolic disease. We assessed education and income annually from population registers and work stress, defined as job strain, with a job-exposure matrix. Outcomes were ascertained until 2014 from health registers and risk was estimated using Cox regression. During 10 957 399 (men) and 10 776 516 person-years (women), we identified 51 585 and 24 075 incident CVD cases, respectively. For men with low education, risk of CVD was 1.62 [95% confidence interval (CI) 1.58–1.66] before and 1.46 (95% CI 1.42–1.50) after adjustment for income and job strain (25% reduction). In women, estimates were 1.66 (95% CI 1.61–1.72) and 1.53 (95% CI 1.47–1.58) (21% reduction). Of individuals with cardiometabolic disease, 1736 men (362 234 person-years) and 341 women (179 402 person-years) died from CVD. Education predicted CVD mortality in both sexes. Estimates were reduced with 54% (men) and 33% (women) after adjustment for income and job strain.Conclusion: Low education predicted incident CVD in initially healthy individuals and CVD mortality in individuals with prevalent cardiometabolic disease. In men with cardiometabolic disease, income and job strain explained half of the higher CVD mortality in the low education group. In healthy men and in women regardless of cardiometabolic disease, these factors explained 21–33% of the higher CVD morbidity and mortality.
Subject headings
- SAMHÄLLSVETENSKAP -- Psykologi (hsv//swe)
- SOCIAL SCIENCES -- Psychology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- 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
- nationwide study
- universal coverage
- social determinants
- mechanisms
- cardiovascular disease
- cardiovascular mortality
- Psychology
- psykologi
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Framke, Elisabet ...
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Sørensen, Jeppe ...
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Andersen, Per Kr ...
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Svane-Petersen, ...
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Alexanderson, Kr ...
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Bonde, Jens Pete ...
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show more...
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Farrants, Kristi ...
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Meulengracht Fla ...
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Magnusson Hanson ...
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Nyberg, Solja T
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Villadsen, Ebbe
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Kivimäki, Mika
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Rugulies, Reiner
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Madsen, Ida E H
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show less...
- About the subject
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- SOCIAL SCIENCES
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SOCIAL SCIENCES
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and Psychology
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Health Sciences
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and Public Health Gl ...
- Articles in the publication
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European Heart J ...
- By the university
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Stockholm University
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Karolinska Institutet