title: Widening inequalities in the risk factors for cardiovascular disease amongst men in England between 1998 and 2006.
abstract: OBJECTIVE
  Cardiovascular disease is a major cause of morbidity and mortality for which there are many modifiable risk factors. This study investigated changes in social inequalities of cardiovascular disease risk factors amongst men aged 20-64 years in England between 1998 and 2006.
  
  
  METHODS
  Repeated cross-sectional study.
  
  
  METHODS
  Health Survey for England data from 1998, 2003 and 2006 were used. The following physiological risk factors were considered: body mass index, waist-to-hip ratio, blood pressure and total serum cholesterol level. The behavioural risk factors considered were limited physical exercise, smoking status and level of social support. The National Statistics Socio-economic Classification was used to measure socio-economic position. An index of inequality for each risk factor was calculated, and change in inequality over time was assessed by t-tests.
  
  
  RESULTS
  Significant cross-sectional inequality was found for waist-to-hip ratio, systolic blood pressure, smoking, limited physical exercise and social support at one or more time points. Between 1998 and 2006, there was a significant increase in inequality for smoking status [relative index of inequality (RII) 4.06-6.65 (t-test: 2.88, P = 0.003)] and limited physical exercise [RII 1.06-1.74 (t-test: 2.92, P = 0.003)]; these increases in inequality over time were due to improvements for those in higher socio-economic classes.
  
  
  CONCLUSIONS
  Policies have not had the desired impact of reducing inequalities. Although the long-term effects of these policies might not yet be apparent, available evidence needs to be used to monitor impact and direct policy change to address the possibility of widening inequalities.
authors.affiliation: School of Health and Human Sciences, University of Essex, Colchester CO4 3SQ, UK.
authors.forename: C
authors.initials: C
authors.lastname: Rumble
authors.forename: D J
authors.initials: DJ
authors.lastname: Pevalin
mesh_terms: D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D057185:Sedentary Behavior; D012907:Smoking / Q000453:epidemiology; D012944:Social Support; D012959:Socioeconomic Factors; D049629:Waist-Hip Ratio; D055815:Young Adult
chemical_list: D002784:Cholesterol