title: Socioeconomic status and coronary heart disease risk factor trends. The Minnesota Heart Survey.
abstract: BACKGROUND
  Socioeconomic status (SES) indicators including education, income, and occupation are associated with coronary heart disease (CHD) risk factors, morbidity, and mortality. In most industrialized nations, individuals with less education, lower income, and blue collar occupations have the highest CHD rates. It is suggested by some that these differences by SES are increasing even as age-adjusted CHD mortality declines.
  
  
  RESULTS
  The Minnesota Heart Survey includes measurement of CHD risk factors and behaviors in population-based samples of Minneapolis-St. Paul adults aged 25 to 74 years in 1980 to 1982 (N = 3243) and 1985 to 1987 (N = 4538). Education was significantly and inversely related to blood pressure, cigarette smoking, body mass index, and a summary risk score for both men and women. Serum cholesterol was inversely related to education in women but not in men. Education was positively associated with leisure physical activity and health knowledge. Associations with household income were less consistent in magnitude and direction. Risk characteristics improved significantly between the 1980 to 1982 and 1985 to 1987 surveys. These changes were similar across education and household income levels.
  
  
  CONCLUSIONS
  Improvement in CHD risk factors over time unrelated to education or income suggests that population-wide factors such as improved health knowledge, availability of healthy food items, hypertension treatment, and restrictions on cigarette smoking are operating beneficially in all SES groups. Although the SES gradient in risk factors is not increasing, it remains substantial and indicates directions for future prevention efforts.
authors.affiliation: Division of Epidemiology, University of Minnesota, Minneapolis 55454-1015.
authors.forename: R V
authors.initials: RV
authors.lastname: Luepker
authors.forename: W D
authors.initials: WD
authors.lastname: Rosamond
authors.forename: R
authors.initials: R
authors.lastname: Murphy
authors.forename: J M
authors.initials: JM
authors.lastname: Sprafka
authors.forename: A R
authors.initials: AR
authors.lastname: Folsom
authors.forename: P G
authors.initials: PG
authors.lastname: McGovern
authors.forename: H
authors.initials: H
authors.lastname: Blackburn
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D003327:Coronary Disease / Q000209:etiology*; D005260:Female; D006266:Health Education; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D009043:Motor Activity; D012307:Risk Factors; D012907:Smoking; D012923:Social Class; D013599:Systole
chemical_list: D000959:Antihypertensive Agents; D002784:Cholesterol