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Socioeconomic position, co-occurrence of behavior-related risk factors, and coronary heart Disease: The finnish public sector study

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  • Kivimäki, M.
  • Lawlor, D.A.
  • Smith, G.D.
  • Kouvonen, A.
  • Virtanen, M.
  • Elovainio, M.
  • Vahtera, J.

Abstract

Objectives. We examined the associations between socioeconomic position, co-occurrence of behavior-related risk factors, and the effect of these factors on the relative and absolute socioeconomic gradients in coronary heart disease. Methods. We obtained the socioeconomic position of 9337 men and 39 255 women who were local government employees aged 17-65 years from employers' records (the Public Sector Study, Finland). A questionnaire survey in 2000-2002 was used to collect data about smoking, heavy alcohol consumption, physical inactivity, obesity, and prevalence of coronary heart disease (myocardial infarction or angina diagnosed by a doctor). Results. The age-adjusted odds of coronary heart disease were 2.1-2.2 times higher for low-income groups than high-income groups for both men and women, and adjustment for risk factors attenuated these associations by 13%-29%. There was no further attenuation with additional adjustment for the number of co-occurring risk factors, although socioeconomic disadvantage was associated with the co-occurrence of multiple risk factors. The absolute difference in coronary heart disease risk between socioeconomic groups could not be attributed to the measured risk factors. Conclusions. Interventions to reduce adult behavior-related risk factors may not completely remove socioeconomic differences in relative or absolute coronary heart disease risk, although they would lessen these effects.

Suggested Citation

  • Kivimäki, M. & Lawlor, D.A. & Smith, G.D. & Kouvonen, A. & Virtanen, M. & Elovainio, M. & Vahtera, J., 2007. "Socioeconomic position, co-occurrence of behavior-related risk factors, and coronary heart Disease: The finnish public sector study," American Journal of Public Health, American Public Health Association, vol. 97(5), pages 874-879.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2005.078691_0
    DOI: 10.2105/AJPH.2005.078691
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    1. Fulvio Ricceri & Carlotta Sacerdote & Maria Teresa Giraudo & Francesca Fasanelli & Giulia Lenzo & Matteo Galli & Sabina Sieri & Valeria Pala & Giovanna Masala & Benedetta Bendinelli & Rosario Tumino &, 2016. "The Association between Educational Level and Cardiovascular and Cerebrovascular Diseases within the EPICOR Study: New Evidence for an Old Inequality Problem," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-15, October.
    2. Emma Björkenstam & Anders Hjern & Ellenor Mittendorfer-Rutz & Bo Vinnerljung & Johan Hallqvist & Rickard Ljung, 2013. "Multi-Exposure and Clustering of Adverse Childhood Experiences, Socioeconomic Differences and Psychotropic Medication in Young Adults," PLOS ONE, Public Library of Science, vol. 8(1), pages 1-9, January.
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    6. Seppälä, Piia & Olin, Nina & Kalavainen, Susanna & Clottes Heikkilä, Heli & Kivimäki, Mika & Remes, Jouko & Ervasti, Jenni, 2023. "Effectiveness of a workshop-based intervention to reduce bullying and violence at work: A 2-year quasi-experimental intervention study," Social Science & Medicine, Elsevier, vol. 338(C).
    7. Sabbah, Wael & Tsakos, Georgios & Sheiham, Aubrey & Watt, Richard G., 2009. "The role of health-related behaviors in the socioeconomic disparities in oral health," Social Science & Medicine, Elsevier, vol. 68(2), pages 298-303, January.
    8. Fujishiro, Kaori & Xu, Jun & Gong, Fang, 2010. "What does "occupation" represent as an indicator of socioeconomic status?: Exploring occupational prestige and health," Social Science & Medicine, Elsevier, vol. 71(12), pages 2100-2107, December.
    9. Khang, Young-Ho & Lynch, John W. & Yang, Seungmi & Harper, Sam & Yun, Sung-Cheol & Jung-Choi, Kyunghee & Kim, Hye Ryun, 2009. "The contribution of material, psychosocial, and behavioral factors in explaining educational and occupational mortality inequalities in a nationally representative sample of South Koreans: Relative an," Social Science & Medicine, Elsevier, vol. 68(5), pages 858-866, March.
    10. Samir KC & Harold Lentzner, 2010. "The effect of education on adult mortality and disability: a global perspective," Vienna Yearbook of Population Research, Vienna Institute of Demography (VID) of the Austrian Academy of Sciences in Vienna, vol. 8(1), pages 201-235.
    11. Jaana I Halonen & Mika Kivimäki & Jaana Pentti & Ichiro Kawachi & Marianna Virtanen & Pekka Martikainen & S V Subramanian & Jussi Vahtera, 2012. "Quantifying Neighbourhood Socioeconomic Effects in Clustering of Behaviour-Related Risk Factors: A Multilevel Analysis," PLOS ONE, Public Library of Science, vol. 7(3), pages 1-8, March.

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