title: Socioeconomic status and ischaemic heart disease mortality in 10 western European populations during the 1990s.
abstract: OBJECTIVE
  To assess the association between socioeconomic status and ischaemic heart disease (IHD) mortality in 10 western European populations during the 1990s.
  
  
  METHODS
  Longitudinal study.
  
  
  METHODS
  10 European populations (95,009,822 person years).
  
  
  METHODS
  Longitudinal data on IHD mortality by educational level were obtained from registries in Finland, Norway, Denmark, England/Wales, Belgium, Switzerland, Austria, Turin (Italy), Barcelona (Spain), and Madrid (Spain). Age standardised rates and rate ratios (RRs) of IHD mortality by educational level were calculated by using Poisson regression.
  
  
  RESULTS
  IHD mortality was higher in those with a lower socioeconomic status than in those with a higher socioeconomic status among men aged 30-59 (RR 1.55, 95% confidence interval (CI) 1.51 to 1.60) and 60 years and over (RR 1.22, 95% CI 1.21 to 1.24), and among women aged 30-59 (RR 2.13, 95% CI 1.98 to 2.29) and 60 years and over (RR 1.36, 95% CI 1.33 to 1.38). Socioeconomic disparities in IHD mortality were larger in the Scandinavian countries and England/Wales, of moderate size in Belgium, Switzerland, and Austria, and smaller in southern European populations among men and younger women (p < 0.0001). For elderly women the north-south gradient was smaller and there was less variation between populations. No socioeconomic disparities in IHD mortality existed among elderly men in southern Europe.
  
  
  CONCLUSIONS
  Socioeconomic disparities in IHD mortality were larger in northern than in southern European populations during the 1990s. This partly reflects the pattern of socioeconomic disparities in cardiovascular risk factors in Europe. Population wide strategies to reduce risk factor prevalence combined with interventions targeted at the lower socioeconomic groups can contribute to reduce IHD mortality in Europe.
authors.affiliation: Department of Public Health, Erasmus Medical Centre, Rotterdam,The Netherlands. m.avendanopabon@erasmusmc.nl
authors.forename: M
authors.initials: M
authors.lastname: Avendano
authors.forename: A E
authors.initials: AE
authors.lastname: Kunst
authors.forename: M
authors.initials: M
authors.lastname: Huisman
authors.forename: F V
authors.initials: FV
authors.lastname: Lenthe
authors.forename: M
authors.initials: M
authors.lastname: Bopp
authors.forename: E
authors.initials: E
authors.lastname: Regidor
authors.forename: M
authors.initials: M
authors.lastname: Glickman
authors.forename: G
authors.initials: G
authors.lastname: Costa
authors.forename: T
authors.initials: T
authors.lastname: Spadea
authors.forename: P
authors.initials: P
authors.lastname: Deboosere
authors.forename: C
authors.initials: C
authors.lastname: Borrell
authors.forename: T
authors.initials: T
authors.lastname: Valkonen
authors.forename: R
authors.initials: R
authors.lastname: Gisser
authors.forename: J-K
authors.initials: JK
authors.lastname: Borgan
authors.forename: S
authors.initials: S
authors.lastname: Gadeyne
authors.forename: J P
authors.initials: JP
authors.lastname: Mackenbach
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000401:mortality*; D017678:Sex Distribution; D012923:Social Class