Socially deprived young Scots vulnerable to CHD death
MedWire News: Young men and women from the most socially deprived backgrounds in Scotland are around six times more likely to die from coronary heart disease (CHD) than their affluent peers, research suggests.
The disparity in CHD mortality decreased with age, but only disappeared for individuals aged 85 years and over.
Their findings lead Simon Capewell (University of Liverpool, UK) and colleagues to call premature death from CHD “a major contributor to social inequalities.”
The team studied vital statistics from people in Scotland aged 35 years an older obtained between 1986 and 2006.
During this period, age-adjusted CHD mortality decreased by 60.9% in men and by 56.4% in women, with fairly steady declines in middle-aged and older adults.
However, the decline in CHD deaths flattened among younger men and women, with this limited to the more deprived groups studied.
CHD mortality levelled off from 1994 among young men and women aged 35 to 44 years, and from about 2003 in those aged 45 to 54 years. The flattening of CHD mortality in younger men and women was confined to the two most deprived groups.
Rates in women aged 55 to 64 years may also now be flattening, the researchers say.
Reporting in the BMJ, they propose: “These changes in mortality reflect social gradients in unhealthy behaviour, lifestyle, and circumstances resulting in poor diet and high tobacco consumption leading to unfavorable levels of major risk factors for CHD.”
Alastair Leyland (MRC Social and Public Health Sciences Unit, Glasgow) and John Lynch (University of South Australia, Adelaide) pointed out in an accompanying editorial that interventions to reduce health inequalities through modifying major risk factors have had limited success to date.
They suggested: “The alternative is to tackle the social inequalities themselves - unequal distribution of power, money, resources, and life chances.”
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009
By Anita Wilkinson