Do socioeconomic characteristics of neighbourhood of residence independently influence incidence of coronary heart disease and all-cause mortality in older British men?
BACKGROUND
The relationship between coronary heart disease (CHD) incidence and death, and individual sociodemographic status is well established. Our aim was to examine whether neighbourhood deprivation scores predict CHD and death in older men, independently of individual sociodemographic status.


METHODS
Prospective study of 5049 men, born between 1918 and 1939, recruited from 24 British towns encompassing 969 electoral wards, without documented evidence of previous major CHD when responding to a questionnaire in 1992, and followed up for incidence of major CHD and death.


RESULTS
Four hundred and seventy-two new major CHD events (1.08% pa), and 1021 deaths (2.28% pa) occurred over an average of 9.75 years. When men were divided into fifths according to increasing neighbourhood deprivation score, CHD incidences (% pa) were 0.92, 0.89, 0.99, 1.33 and 1.29. When modelling continuous trends, the rate ratio for men in the top fifth compared with the bottom fifth was 1.55 (95% confidence interval 1.19-2.00) for CHD. This rate ratio was, however, no longer statistically significant [1.22 (95% confidence interval 0.92-1.61)] when effects of individual sociodemographic status measures (car ownership, housing, longest held occupation, marital status and social networks) were accounted for.


CONCLUSIONS
Little evidence of an independent relationship of neighbourhood deprivation with CHD incidence was found once individual measures of sociodemographic status had been adjusted for.
Morris
Richard W
RW
Royal Free and University College Medical School, Hampstead Campus, Hampstead, London, UK. r.morris@pcps.ucl.ac.uk
Wannamethee
Goya
G
Lennon
Lucy T
LT
Thomas
Mary C
MC
Whincup
Peter H
PH
D000328:Adult; D002423:Cause of Death; D003327:Coronary Disease / Q000401:mortality*; D004739:England / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011204:Poverty Areas; D011446:Prospective Studies; D012111:Residence Characteristics; D012923:Social Class; D011795:Surveys and Questionnaires