[Disease, physician-patient contacts and work disability in a general practice]
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Coronary Heart Disease symptoms and risk factors increased in lower social classes. This correlated with more physician visits and work disability days, highlighting socioeconomic health disparities.
Area of Science:
- Preventive medicine
- Social epidemiology
- Cardiology
Background:
- Socioeconomic status is linked to health outcomes.
- Understanding risk factors for Coronary Heart Disease (CHD) is crucial for preventive strategies.
- Previous research indicates disparities in health across social classes.
Purpose of the Study:
- To investigate the relationship between social class, CHD symptoms, risk factors, and healthcare utilization.
- To assess the prevalence of autonomic nervous system disorders and hyperuricemia across social strata.
- To determine if work disability and physician contacts differ by social class and health status.
Main Methods:
- A screening program recorded CHD symptoms (G. Rose questionnaire) and risk factors in 314 men.
- Physician-patient contacts and work disability days were registered.
- Participants were categorized into four social classes.
Main Results:
- Lower social classes showed significantly higher rates of autonomic nervous disorder symptoms and hyperuricemia.
- Smoking prevalence increased significantly with descending social class.
- Physician-patient contacts and work disability days also trended higher in lower social classes.
- Patients with vegetative symptoms or abnormal ECG findings had significantly more physician contacts and work disability days compared to a control group.
Conclusions:
- Socioeconomic status is a significant determinant of CHD symptoms and risk factors.
- Lower social classes experience a greater burden of disease and healthcare utilization.
- These findings underscore the need for targeted preventive interventions for disadvantaged populations.
Abstract:
The frequency of Coronary Heart Disease symptoms (questionnaire from G. Rose) and some risk factors were recorded for 314 men in a general practice as part of a preventive screening programme. Simultaneously the number of physician-patient contacts and the total days of work disability were registered. The patients were divided into four social classes. There was a significant increase of symptoms of autonomic nervous disorder and hyperuricemia (p less than 0,025) as well as the number of smokers (p less than 0,001) with descending social class. The same trend was found with the frequency of physician-patient contacts and the total days of work disability (p less than 0,1). Patients with vegetative symptoms showed a mean of 7,2 physician-patient contacts and a work disability of 37,4 days per year. For patients with abnormal ECG findings the rates were 5,6 contacts and 33,4 days of disability per year. There was a significant difference in these rates compared to a control group.