In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 144, No. Suppl_1 ( 2021-11-16)
Abstract:
Introduction: There is increasing interest in the role of income level as a social determinant of health for cardiovascular disease (CVD). In this study we examine the interplay of household income, all-cause mortality, and CVD mortality in a representative US adult population. Methods: We used National Health Interview Survey data from 2006-2014 including adults ≥18 years. Mortality data with follow-up till December 2015 was derived from the National Death Index. We evaluated age-adjusted all-cause, CVD and non-CVD mortality rates across income levels (lowest, low, middle, and high; defined based on based on the percentage of family income relative to the federal poverty level), among people with and without ASCVD at baseline. We further classified participants without ASCVD as having optimal (0-1 risk factors), average (2-3), and poor ( 〉 3) cardiovascular risk factor (CRF) profile. Cox regression models were used to evaluate the association between income and mortality. Results: The analysis included 256,991 adults, representing ~230 million adults annually. Mean age was 46.3 (SD=17.7), 52% were women, 13% NHB, and 8% had ASCVD. Overall, 18% were in the lowest income category compared to 39% in highest group. During the 10 years of follow up, participants with highest income and optimal CVH had the lowest all-cause and cause-specific mortality rates, whereas those with lowest income and poor CVH had the highest rates (Figure). Additionally, multivariate adjustment for demographics and CRF, lower income was associated with increased all-cause mortality (lowest/low vs middle/high income, HR: 1.22; 95% CI: 1.11-1.35 CVD vs non-CVD HR: 1.24, 95% CI: 1.16-1.33) and CVD mortality (lowest/low vs middle/high income: HR: 1.29, 95% CI: 1.07-1.56 CVD vs non-CVD HR: 1.44, 95% CI: 1.23-1.67). Conclusions: In a US representative population, lower income adults were consistently associated with increased risk of all-cause and CVD mortality irrespective of baseline CVD status.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/circ.144.suppl_1.13639
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2021
detail.hit.zdb_id:
1466401-X
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