Do socioeconomic characteristics of neighbourhood of residence independently influence incidence of coronary heart disease and all-cause mortality in older British men?

  1. Richard W. Morrisa⇓
  2. Goya Wannametheea
  3. Lucy T. Lennona
  4. Mary C. Thomasa
  5. Peter H. Whincupb
  1. a Royal Free and University College Medical School, Hampstead Campus, Hampstead
  2. b St George’s University of London, London, UK
  1. Correspondence to Dr Richard W. Morris, PhD, Royal Free and University College Medical School, Rowland Hill Street, London NW3 2PF, UK Tel: + 44 020 7472 6766; fax: +44 020 7794 1224; e-mail: r.morris@pcps.ucl.ac.uk

Abstract

Background The relationship between coronary heart disease (CHD) incidence and death, and individual socio-demographic 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.

Conclusion Little evidence of an independent relationship of neighbourhood deprivation with CHD incidence was found once individual measures of sociodemographic status had been adjusted for..

  • Received October 12, 2006.
  • Accepted August 8, 2007.

 

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