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Journal article
Inequalities by Income in the Prevalence of Cardiovascular Disease and Its Risk Factors in the Adult Population of Catalonia
Journal of the American Heart Association, v 11(17), pp e026587-e026587
06 Sep 2022
PMID: 36000437
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background Understanding the magnitude of cardiovascular disease (CVD) inequalities is the first step toward addressing them. The linkage of socioeconomic and clinical data in universal health care settings provides critical information to characterize CVD inequalities. Methods and Results We employed a prospective cohort design using electronic health records data from all residents of Catalonia aged 18+ between January and December of 2019 (N=6 332 228). We calculated age-adjusted sex-specific prevalence of 5 CVD risk factors (diabetes, hypertension, hyperlipidemia, obesity, and smoking), and 4 CVDs (coronary heart disease, cerebrovascular disease, atrial fibrillation, and heart failure). We categorized income into high, moderate, low, and very low according to individual income (tied to prescription copayments) and receipt of welfare support. We found large inequalities in CVD and CVD risk factors among men and women. CVD risk factors with the largest inequalities were diabetes, smoking, and obesity, with prevalence rates 2- or 3-fold higher for those with very low (versus high) income. CVDs with the largest inequalities were cerebrovascular disease and heart failure, with prevalence rates 2 to 4 times higher for men and women with very low (versus high) income. Inequalities varied by age, peaking at midlife (30-50 years) for most diseases, while decreasing gradually with age for smoking. Conclusions We found wide and heterogeneous inequalities by income in 5 CVD risk factors and 4 CVD. Our findings in a region with a high-quality public health care system and universal coverage stress that strong equity-promoting policies are necessary to reduce disparities in CVD.
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Details
- Title
- Inequalities by Income in the Prevalence of Cardiovascular Disease and Its Risk Factors in the Adult Population of Catalonia
- Creators
- Pricila H. Mullachery - Temple UniversityEmili Vela - Government of SpainMontse Cleries - Government of SpainJosep Comin-Colet - Government of SpainKhurram Nasir - Houston MethodistAna V. Diez Roux - Urban Health Collaborative Drexel Dornsife School of Public Health Philadelphia PA.Miguel Cainzos-Achirica - Houston MethodistJosepa Mauri - Government of SpainUsama Bilal - Urban Health Collaborative Drexel Dornsife School of Public Health Philadelphia PA.
- Publication Details
- Journal of the American Heart Association, v 11(17), pp e026587-e026587
- Publisher
- Wiley
- Number of pages
- 19
- Grant note
- 284134 / Cotswold Postdoctoral Fellowship DP5OD26429 / Office of the Director of the National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative
- Web of Science ID
- WOS:000850275600008
- Scopus ID
- 2-s2.0-85137550425
- Other Identifier
- 991019189132204721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems