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No evidence for social class inequalities in intervention for coronary heart disease in Otago 1987-9
D Phillips1, I Kawachi, S Marshall
1Department of Community Health, Wellington School of Medicine.
Insights
Social class did not significantly impact access to cardiac surgical interventions like angioplasties and coronary artery bypass grafting. Therefore, disparities in these procedures do not explain social class differences in coronary heart disease mortality.
Area of Science:
- Cardiovascular Medicine
- Public Health
- Health Disparities Research
Background:
- Coronary heart disease (CHD) mortality shows significant inequalities across socioeconomic groups.
- Access to advanced cardiac surgical interventions, such as angioplasties and coronary artery bypass grafting, may be a contributing factor to these disparities.
Purpose of the Study:
- To investigate if social class differences in the utilization of cardiac surgical interventions explain social class-based inequalities in CHD mortality.
- To analyze the relationship between socioeconomic status and access to life-saving cardiac procedures.
Main Methods:
- A cohort of male patients under 65 admitted for incident ischemic heart disease (IHD) between 1987-1989 at Dunedin Hospital was studied.
- Patients' socioeconomic status was determined using the Elley-Irving social class scale.
- Rates of cardiac surgical interventions were calculated across different social classes, adjusting for age.
Main Results:
- No statistically significant trend was found in the cumulative incidence of cardiac surgical interventions (angioplasties, coronary artery bypass grafts) across social classes.
- Incidence rates of these cardiac surgical interventions also showed no significant variation by social class, even after age adjustment.
Conclusions:
- Social class inequalities in access to cardiac surgical interventions do not appear to be the cause of observed social class inequalities in coronary heart disease mortality.
- Further research is needed to identify other factors contributing to socioeconomic disparities in CHD outcomes.
Objects:
to investigate whether social class differences in access to cardiac surgical interventions (angioplasties and coronary artery bypass grafting) could explain social class inequalities in mortality from coronary heart disease.
Methods:
rates of therapeutic interventions to treat coronary heart disease were calculated for male patients aged less than 65 years admitted for the first time to Dunedin Hospital with a principal diagnosis of ischaemic heart disease (ICD codes 410-414) during the three year period from 1 January 1987 to 31 December 1989. Patients were categorised into different socioeconomic groups using the Elley-Irving social class scale.
Results:
no statistically significant trend across social class was observed in the cumulative incidence of cardiac surgical interventions (angioplasties, coronary artery bypass grafts). Similarly there was no statistically significant trend across social class in the incidence rates of cardiac surgical interventions, even after adjustment for age.
Conclusions:
social class inequalities in access to cardiac surgical intervention do not appear to explain the observed inequalities in mortality from coronary heart disease.