Neighborhood Poverty and Incident Heart Failure: an Analysis of Electronic Health Records from 2005 to 2018

Rethy, Leah; McCabe, Megan; Kershaw, Kiarri N.; Ahmad, Faraz; Lagu, Tara; Pool, Lindsay R.; Khan, Sadiya S.

doi:10.1007/s11606-021-06785-7

Cited by 5 publications

(5 citation statements)

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“…Furthermore, the area encompassing sub-regions with a high deprivation in the western part of the country was associated with a more clear trend toward job migrations to work legally abroad. The migrations may exacerbate the optimal development of these areas due to the outflow of human capital and are also associated with a prevalence of social exclusion and poverty, leading altogether to health hazards [26,62]. Some analyses indicate that the eastern and northwestern parts of the country have high total mortality due to CSD of the age group 25-64 years [63].…”

Section: Interpretation Of Resultsmentioning

confidence: 99%

Is area-level socioeconomic deprivation associated with mortality due to circulatory system diseases in Poland?

2023

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Background Socioeconomic deprivation (SED) is known to influence cardiovascular health. However, studies analyzing the relationship between deprivation and circulatory system diseases (CSD) in Central and Eastern Europe are limited. This study aimed to assess the relationship between SED and mortality due to CSD at a population level in 66 sub-regions of Poland. Methods The 2010–2014 data regarding mortality and SED components were obtained from the Central Statistical Office. An area-based SED index was calculated based on the higher education rates, employment structure, wages, unemployment, and poverty. The dynamics of changes in mortality due to CSD was expressed by the number of deaths prevented or postponed (DPP) in terciles of the SED index. The associations between the mortality from CSD and SED index were analyzed using multivariate Poisson regression models and generalized estimating equations. Results Among men, the percentage of DPP in 2014 was 13.1% for CSD, 23.4% for ischemic heart disease (IHD), and 21.4% for cerebrovascular diseases (CeVD). In the case of women, the proportion of DPP was 12.8, 25.6, and 21.6%, respectively. More deprived sub-regions experienced a greater decrease in CSD-related mortality than less deprived sub-regions. The disparity in mortality reduction between more deprived and less deprived sub-regions was even more pronounced for women. After adjusting for smoking prevalence, average BMI, population density, and changes in mortality over time, it was found that the SED index over the 2010–2014 time period was significantly associated with CSD- and IHD-related mortality for men (respectively 5.3 and 19.5% expected mortality increase per 1-unit increase of SED index), and with IHD- and CeVD-related mortality for women (respectively 30.3 and 23.0% expected mortality increase per 1-unit increase of SED index). Conclusions Significant differences in mortality changes due to CSD in Poland could be observed in relation to socioeconomic deprivation, resulting in reduced health inequalities. To reduce CSD mortality, more comprehensive preventive measures, including approaches addressing the socioeconomic factors, mainly poverty, education and employment, are needed, particularly in less urbanized areas.

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Section: Interpretation Of Resultsmentioning

confidence: 99%

Is area-level socioeconomic deprivation associated with mortality due to circulatory system diseases in Poland?

2023

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“…Furthermore, the area encompassing sub-regions with a high deprivation in the western part of the country was associated with a more explicit trend toward job migrations to work legally abroad. The migrations may exacerbate a optimal development of these areas due to out ow of human capital, and are also associated with a prevalence of social exclusion and poverty, leading altogether to health hazards [26,55].…”

Section: Interpretation Of Resultsmentioning

confidence: 99%

Is area-level socioeconomic deprivation associated with mortality due to circulatory system diseases in Poland?

Jamiołkowski

Genowska

Pająk

2022

Preprint

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Background. Socioeconomic deprivation (SED) is known to influence cardiovascular health. However, studies analyzing the relationship between deprivation and circulatory system diseases (CSD) in Central and Eastern Europe are limited. This study aimed to assess the relationship between SED and mortality due to CSD at a population level in 66 sub-regions of Poland. Methods. The data regarding mortality and SED components were obtained from the Central Statistical Office. An area-based SED index was estimated from the rates of education, structure in employment, salary, unemployment, as well as and poverty. The dynamics of changes in mortality due to CSD was calculated as the number of deaths prevented or postponed (DPP) in terciles of SED index. The associations between the mortality from CSD and SED index were analyzed using multivariate Poisson regression models and generalized estimating equations. Results. Among men, the percentage of DPP in 2014 was 13.1% for CSD, 23.4% for ischemic heart disease (IHD), and 21.4% for cerebrovascular diseases (CD). In the case of women, the proportion of DPP was 12.8%, 25.6%, and 21.6%, respectively. More deprived sub-regions experienced a greater decrease in CSD-related mortality compared to the less deprived sub-regions. The disparity in mortality reduction between more deprived and less deprived sub-regions was even more pronounced for women. After adjustment for lifestyle, population density, and changes in mortality over time, the SED index was found to be associated with CSD- and IHD-related mortality for men (β = 1.053, 95% confidence interval (CI) 1.008–1.100 and β = 1.195, 95% CI 1.005–1.419, respectively), and with IHD- and CD-related mortality for women (β = 1.303, 95% CI 1.025–1.657 and β = 1.230, 95% CI 1.025–1.477, respectively). Conclusions. A major proportion of the territorial differences in mortality due to CSD in Poland could be attributed to socioeconomic deprivation. To reduce CSD mortality, more comprehensive preventive measures, including approaches addressing the socioeconomic factors, mainly poverty, education and employment, in particular in less urbanized areas are needed.

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“…Using all of the available census tractlevel poverty estimates for Illinois, we calculated tertiles of this proportion to derive three categories of neighborhood poverty (Fig. 2): low poverty (proportion below poverty threshold less than 0.073, which translates to approximately 7% of the census tract living below the US-defined poverty threshold), intermediate poverty (proportion below poverty threshold from 0.073 to 0.16, or between 7 and 16% of households living below the poverty threshold), and high poverty (proportion below poverty threshold greater than 0.16, or greater than 16% of households living below the poverty threshold) [22,23].…”

Section: Primary Exposure and Outcome Ascertainmentmentioning

confidence: 99%

Association Between Neighborhood-Level Poverty and Incident Atrial Fibrillation: a Retrospective Cohort Study

et al. 2021

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BACKGROUND: Atrial fibrillation (AF) is a leading cause of cardiovascular morbidity and mortality. While neighborhood-level factors, such as poverty, have been related to prevalence of AF risk factors, the association between neighborhood poverty and incident AF has been limited. OBJECTIVE: Using a large cohort from a health system serving the greater Chicago area, we sought to determine the association between neighborhood-level poverty and incident AF. DESIGN: Retrospective cohort study. PARTICIPANTS: Adults, aged 30 to 80 years, without baseline cardiovascular disease from January 1, 2005, to December 31, 2018. MAIN MEASURES: We geocoded and matched residential addresses of all eligible patients to census-level poverty estimates from the American Community Survey. Neighborhood-level poverty (low, intermediate, and high) was defined as the proportion of residents in the census tract living below the federal poverty threshold. We used generalized linear mixed effects models with a logit link function to examine the association between neighborhood poverty and incident AF, adjusting for patient demographic and clinical AF risk factors. KEY RESULTS: Among 28,858 in the cohort, patients in the high poverty group were more often non-Hispanic Black or Hispanic and had higher rates of AF risk factors. Over 5 years of follow-up, 971 (3.4%) patients developed incident AF. Of these, 502 (51.7%) were in the low poverty, 327 (33.7%) in the intermediate poverty, and 142 (14.6%) in the high poverty group. The adjusted odds ratio (aOR) of AF was higher for the intermediate poverty compared with that for the low poverty group (aOR 1.23 [95% CI 1.01-1.48]). The point estimate for the aOR of AF incidence was similar, but not statistically significant, for the high poverty compared with the low poverty group (aOR 1.25 [95% CI 0.98-1.59]). CONCLUSION: In adults without baseline cardiovascular disease managed in a large, integrated health system, intermediate neighborhood poverty was significantly associated with incident AF. Understanding neighborhoodlevel drivers of AF disparities will help achieve equitable care.

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Neighborhood Poverty and Incident Heart Failure: an Analysis of Electronic Health Records from 2005 to 2018

Cited by 5 publications

References 50 publications

Is area-level socioeconomic deprivation associated with mortality due to circulatory system diseases in Poland?

Is area-level socioeconomic deprivation associated with mortality due to circulatory system diseases in Poland?

Is area-level socioeconomic deprivation associated with mortality due to circulatory system diseases in Poland?

Association Between Neighborhood-Level Poverty and Incident Atrial Fibrillation: a Retrospective Cohort Study

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