title: Neighborhood socioeconomic characteristics and statin medication in patients with myocardial infarction: a Swedish nationwide follow-up study.
abstract: Coronary heart disease (CHD) and myocardial infarction (MI) are associated with neighborhood-level socioeconomic status (SES). Statins are important drugs for secondary prevention of MI. However, no study has determined whether neighborhood-level SES is associated with statin medication in MI patients. We aimed to determine whether there is a difference in statin medication rate in MI patients across different levels of neighborhood SES.
  
  
  
  All patients in Sweden, diagnosed with incident MI from January 1st, 2000 until December 31(st) 2010, were followed (n = 116,840). Of these, 89.7 % received statin medication. Data were analyzed by multilevel logistic regression, with individual-level characteristics (age, marital status, family income, educational attainment, country of origin, urban/rural status and comorbidities/chronic conditions related to MI) as covariates.
  
  
  
  Low neighborhood-level SES was significantly associated with low statin medication rate (Odds Ratio 0.80). In the full model, which took into account individual-level socioeconomic characteristics and MI comorbidities, the odds no longer remained significant.
  
  
  
  Individual-level approaches may be most important in health care policies regarding statin medication in MI patients.
authors.affiliation: Center for Primary Health Care Research, Clinical Research Centre (CRC), Lund University, building 28, floor 11, Jan Waldenströms gata 35, SE-205 02, Malmö, Sweden.
authors.forename: Per-Ola
authors.initials: PO
authors.lastname: Forsberg
authors.affiliation: Center for Primary Health Care Research, Clinical Research Centre (CRC), Lund University, building 28, floor 11, Jan Waldenströms gata 35, SE-205 02, Malmö, Sweden. Xinjun.li@med.lu.se.
authors.forename: Xinjun
authors.initials: X
authors.lastname: Li
authors.affiliation: Center for Primary Health Care Research, Clinical Research Centre (CRC), Lund University, building 28, floor 11, Jan Waldenströms gata 35, SE-205 02, Malmö, Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Sundquist
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D011159:Population Surveillance / Q000379:methods*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*; D012959:Socioeconomic Factors; D013548:Sweden / Q000453:epidemiology
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Myocardial infarction; Neighborhood deprivation; Socioeconomic status; Statins