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Low control beliefs, classical coronary risk factors, and socio-economic differences in heart disease in older

H Bosma1, C H M Van Jaarsveld, J Tuinstra

  • 1Health Care Studies, Medical Sociology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. hans.bosma@zw.unimaas.nl

Social Science & Medicine (1982)
|December 2, 2004
PubMed

Insights

Low socioeconomic status groups face higher heart disease risks, primarily due to lower control beliefs, not just classical risk factors. This finding highlights a significant, independent pathway influencing cardiovascular health disparities.

Area of Science:

  • Public Health
  • Epidemiology
  • Psychology

Background:

  • Socioeconomic status (SES) is linked to health disparities.
  • Classical coronary risk factors partially explain these disparities.
  • The role of psychological factors like control beliefs remains under investigation.

Purpose of the Study:

  • To investigate if low control beliefs mediate higher heart disease risk in low SES groups.
  • To compare the impact of control beliefs versus classical risk factors on SES-related heart disease risk.
  • To determine if the effect of control beliefs is independent of classical risk factors.

Main Methods:

  • Population-based prospective cohort study in The Netherlands.
  • Inclusion of 3888 participants aged 57+ without prevalent heart disease in 1993.
  • 5-year follow-up to register incident heart disease (myocardial infarction, congestive heart failure).

Main Results:

  • Low SES individuals had a 45% higher risk of heart disease (RR=1.45).
  • Control beliefs accounted for 30% of SES-related heart disease differences.
  • Classical risk factors accounted for only 4% of these differences.
  • The influence of control beliefs was largely independent of classical risk factors.

Conclusions:

  • Low control beliefs significantly contribute to socioeconomic inequalities in heart disease risk.
  • Psychological factors, specifically control beliefs, play a more substantial role than classical risk factors.
  • Interventions targeting control beliefs may help reduce heart disease disparities in lower SES populations.

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