title: Income and heart disease: Neglected risk factor.
abstract: OBJECTIVE
  To determine the unadjusted and adjusted effects of income on heart disease; its main disease intermediary, high blood pressure; and its main behavioural risk factors, smoking and physical inactivity.
  
  
  METHODS
  Random-digit dialing telephone survey collected through the Canadian Community Health Survey by Statistics Canada.
  
  
  METHODS
  Saskatchewan.
  
  
  METHODS
  A total of 27 090 residents aged 20 years and older; each health region in Saskatchewan was represented.
  
  
  METHODS
  Overall, 178 variables related to demographic characteristics, socioeconomic factors, behaviour, life stress, disease intermediaries, health outcomes, and access to health care were analyzed to determine their unadjusted and adjusted effects on heart disease.
  
  
  RESULTS
  The mean age of the sample was 52.6 years. Women represented 55.9% of the sample. Most respondents were married (52.3%) and had some postsecondary or graduate education (52.5%). The mean personal income was $23 931 and the mean household income was $37 533. All models statistically controlled for age. Five covariates independently associated with heart disease included high blood pressure, household income of $29 999 or less per year, being a daily smoker, male sex, and being physically inactive. Five covariates independently associated with high blood pressure included being overweight or obese, being a daily smoker, household income of $29 999 or less per year, male sex, and being physically inactive. Five covariates independently associated with daily smoking included being a visible minority, household income of $29 999 or less per year, not being overweight or obese, education level of less than secondary school, and male sex. Six covariates independently associated with physical inactivity included being a visible minority, being overweight or obese, education level of less than secondary school, male sex, household income of $29 999 or less per year, and being a daily smoker.
  
  
  CONCLUSIONS
  Household income was strongly and independently associated with heart disease; its main disease intermediary, high blood pressure; and its main behavioural risk factors, smoking and physical inactivity. Income inequality is a neglected risk factor worthy of appropriate public debate and policy intervention.
authors.affiliation: Adjunct Professor in the College of Medicine at the University of Saskatchewan in Saskatoon. marklemstra@shaw.ca.
authors.forename: Mark
authors.initials: M
authors.lastname: Lemstra
authors.affiliation: Researcher in the College of Medicine at the University of Saskatchewan.
authors.forename: Marla
authors.initials: M
authors.lastname: Rogers
authors.affiliation: Assistant Professor in the School of Public Health at the University of Saskatchewan.
authors.forename: John
authors.initials: J
authors.lastname: Moraros
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004522:Educational Status; D005260:Female; D006306:Health Surveys; D006331:Heart Diseases / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007182:Income / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D012307:Risk Factors; D012525:Saskatchewan / Q000453:epidemiology; D057185:Sedentary Behavior / Q000208:ethnology; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology* / Q000208:ethnology; D055815:Young Adult
references.citation: Can J Psychiatry. 2009 Sep;54(9):589-95
references.pmid: 19751547
references.citation: Am J Public Health. 2001 Dec;91(12):1995-2003
references.pmid: 11726382
references.citation: Prev Med. 2002 Dec;35(6):601-11
references.pmid: 12460528
references.citation: Health Rep. 2002;13(3):9-14
references.pmid: 12743956
references.citation: Can J Public Health. 2009 Jan-Feb;100(1):51-4
references.pmid: 19263984
references.citation: Can J Public Health. 2009 May-Jun;100(3):180-3
references.pmid: 19507718
references.citation: CMAJ. 2009 Aug 4;181(3-4):E55-66
references.pmid: 19620271