Relationship between socioeconomic status and incidence of out-of-hospital cardiac arrest is dependent on age.
DEMOGRAPHY
EDUCATION
Epidemiology of cardiovascular disease
INEQUALITIES
SOCIAL EPIDEMIOLOGY
SOCIAL INEQUALITIES
Journal
Journal of epidemiology and community health
ISSN: 1470-2738
Titre abrégé: J Epidemiol Community Health
Pays: England
ID NLM: 7909766
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
27
10
2019
revised:
02
04
2020
accepted:
21
04
2020
pubmed:
10
5
2020
medline:
3
9
2021
entrez:
10
5
2020
Statut:
ppublish
Résumé
The association between socioeconomic status (SES) and incidence of out-of-hospital cardiac arrest (OHCA) is not fully understood. The aim of this study was to see if area-level socioeconomic differences, measured in terms of area-level income and education, are associated with the incidence of OHCA, and if this relationship is dependent on age. We included OHCAs that occurred in Stockholm County between the 1st of January 2006 and the 31st of December 2017, the victims being confirmed residents (n=10 574). We linked the home address to a matching neighbourhood (base unit) via available socioeconomic and demographic information. Socioeconomic variables and incidence rates were assessed by using cross-sectional values at the end of each year. We used zero-inflated negative binomial regression to calculate incidence rate ratios (IRRs). Among 1349 areas with complete SES information, 10 503 OHCAs occurred between 2006 and 2017. The IRR in the highest versus the lowest SES area was 0.61 (0.50-0.75) among persons in the 0-44 age group. Among patients in the 45-64 age group, the corresponding IRR was 0.55 (0.47-0.65). The highest SES areas versus the lowest showed an IRR of 0.59 (0.50-0.70) in the 65-74 age group. In the two highest age groups, no significant association was seen (75-84 age group: 0.93 (0.80-1.08); 85+ age group: 1.05 (0.84-1.23)). Similar crude patterns were seen among both men and women. Areas characterised by high SES showed a significantly lower incidence of OHCA. This relationship was seen up to the age of 75, after which the relationship disappeared, suggesting a levelling effect.
Sections du résumé
BACKGROUND
The association between socioeconomic status (SES) and incidence of out-of-hospital cardiac arrest (OHCA) is not fully understood. The aim of this study was to see if area-level socioeconomic differences, measured in terms of area-level income and education, are associated with the incidence of OHCA, and if this relationship is dependent on age.
METHODS
We included OHCAs that occurred in Stockholm County between the 1st of January 2006 and the 31st of December 2017, the victims being confirmed residents (n=10 574). We linked the home address to a matching neighbourhood (base unit) via available socioeconomic and demographic information. Socioeconomic variables and incidence rates were assessed by using cross-sectional values at the end of each year. We used zero-inflated negative binomial regression to calculate incidence rate ratios (IRRs).
RESULTS
Among 1349 areas with complete SES information, 10 503 OHCAs occurred between 2006 and 2017. The IRR in the highest versus the lowest SES area was 0.61 (0.50-0.75) among persons in the 0-44 age group. Among patients in the 45-64 age group, the corresponding IRR was 0.55 (0.47-0.65). The highest SES areas versus the lowest showed an IRR of 0.59 (0.50-0.70) in the 65-74 age group. In the two highest age groups, no significant association was seen (75-84 age group: 0.93 (0.80-1.08); 85+ age group: 1.05 (0.84-1.23)). Similar crude patterns were seen among both men and women.
CONCLUSIONS
Areas characterised by high SES showed a significantly lower incidence of OHCA. This relationship was seen up to the age of 75, after which the relationship disappeared, suggesting a levelling effect.
Identifiants
pubmed: 32385129
pii: jech-2019-213296
doi: 10.1136/jech-2019-213296
pmc: PMC7577091
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
726-731Informations de copyright
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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