title: Variation in rates of fatal coronary heart disease by neighborhood socioeconomic status: the atherosclerosis risk in communities surveillance (1992-2002).
abstract: OBJECTIVE
  Racial and gender disparities in out-of-hospital deaths from coronary heart disease (CHD) have been well-documented, yet disparities by neighborhood socioeconomic status (nSES) have been less systematically studied in US population-based surveillance efforts.
  
  
  METHODS
  We examined the association of nSES, classified into tertiles, with 3,743 out-of-hospital fatal CHD events, and a subset of 2,191 events classified as sudden, among persons aged 35 to 74 years in four US communities under surveillance by the Atherosclerosis Risk in Communities (ARIC). Poisson generalized linear mixed models generated age-, race- (white, black) and gender-specific standardized mortality rate ratios and 95% confidence intervals (RR, 95% CI).
  
  
  RESULTS
  Regardless of nSES measure used, inverse associations of nSES with all out-of-hospital fatal CHD and sudden fatal CHD were seen in all race-gender groups. The magnitude of these associations was larger among women than men. Further, among blacks, associations of low nSES (vs. high nSES) were stronger for sudden cardiac deaths (SCD) than for all out-of-hospital fatal CHD.
  
  
  CONCLUSIONS
  Low nSES was associated with an increased risk of out-of-hospital CHD death and SCD. Measures of the neighborhood context are useful tools in population-based surveillance efforts for documenting and monitoring socioeconomic disparities in mortality over time.
authors.affiliation: Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, USA. rforaker@cph.osu.edu
authors.forename: Randi E
authors.initials: RE
authors.lastname: Foraker
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Rose
authors.forename: Anna M
authors.initials: AM
authors.lastname: Kucharska-Newton
authors.forename: Hanyu
authors.initials: H
authors.lastname: Ni
authors.forename: Chirayath M
authors.initials: CM
authors.lastname: Suchindran
authors.forename: Eric A
authors.initials: EA
authors.lastname: Whitsel
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D003327:Coronary Disease / Q000191:economics / Q000208:ethnology* / Q000401:mortality*; D016757:Death, Sudden, Cardiac / Q000208:ethnology; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality; D058687:Out-of-Hospital Cardiac Arrest / Q000208:ethnology; D011159:Population Surveillance; D012307:Risk Factors; D012737:Sex Factors; D012923:Social Class; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*