[Educational status and occupational training, occupational status and ischemic heart diseases: a prospective study with data from statutory health insurance in Germany].
OBJECTIVE
To study associations between education, occupational position, and incidence of ischemic heart disease (ICD-9 410-414).


METHODS
A cohort of 151,471 male and female members of a German statutory health insurance company aged between 25 and 65 years was investigated. The cohort comprised all members between 1987 and 1996. Information on ischemic heart disease was derived from clinical diagnosis. Education, training, and occupational position according to the British Registrar General defined the indicators of social status.


RESULTS
After adjustment for age and length of observation period, education and training as well as occupational position were associated with the incidence of ischemic heart disease in both men and women. Whereas a gradient was observed in men regarding education and training (odds ratios (OR): 3.41-6.02) men with lower occupational position had higher risk estimates as compared to the highest occupational status group (OR: 1.73-3.05). Among women a gradient was observed concerning education and training (OR: 1.75-3.78). With regard to occupational status position female members of the highest group showed the lowest risk as compared to the lower status groups (OR: 1.58-2.19).


CONCLUSIONS
Social inequality in ischemic heart disease morbidity was observed among male and female members of a German statutory health insurance. Findings are of importance for health policy and call for preventive action.
Peter
Richard
R
Abteilung Epidemologie, Arbeitsgruppe Medizinische Soziologie, Universität Ulm. richard.peter@medizin.uni-ulm.de
Yong
Mai
M
Geyer
Siegfried
S
D000328:Adult; D000368:Aged; D002321:Career Choice; D002322:Career Mobility; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D005858:Germany; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology*; D009313:National Health Programs / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012042:Registries / Q000706:statistics & numerical data*