Regional and socioeconomic disparities in cardiovascular disease in Canada during 2005–2016: evidence from repeated nationwide cross-sectional surveys

Abstract

IntroductionThe objective of this study is to examine the temporal trends and patterns of regional and socioeconomic disparities in cardiovascular disease (CVD) in Canada during 2005–2016.MethodsA total of 670 000 adults aged ≥20 years who participated in the Canadian Community Health Surveys between 2005 and 2016 were enrolled for this study. CVD referred to heart disease and stroke in this study. Equivalised household income was used as a proxy of socioeconomic status. Absolute and relative socioeconomic inequalities were measured by slope index of inequality (SII) and relative index of inequality (RII), respectively.ResultsIn 2015/2016, the overall age-adjusted and sex-adjusted prevalence of heart disease and stroke was 4.80% (95% CI 4.61% to 4.98%) and 1.25% (95% CI 1.13% to 1.36%), respectively. Trend analyses suggested a significant decline in the age-adjusted and sex-adjusted prevalence of heart disease (P for trend <0.001) and a non-significant decline in the age-adjusted and sex-adjusted prevalence of stroke (P for trend=0.058) from 2005 to 2016. Nevertheless, the total number of adults suffering from heart disease and stroke increased by 8.9% and 20.2% over the study period, respectively. Moreover, the age-adjusted and sex-adjusted prevalence of heart disease and stroke varied widely across all health regions, and both of them tended be higher among those with lower income. The SII and RII indicated that there were persistent absolute and relative socioeconomic inequalities in heart disease and stroke across all surveys (eg, SII for heart disease in both sexes, 2005: 0.04 (95% CI 0.03 to 0.04); 2015/2016: 0.03 (95% CI, 0.02 to 0.04); RII for heart disease in both sexes, 2005: 1.99 (95% CI 1.75 to 2.27); 2015/2016: 1.77 (95% CI 1.52 to 2.08).ConclusionGeographical and socioeconomic disparities should be taken into account during the further efforts to strengthen preventive measures and optimise healthcare resources for heart disease and stroke in Canada.

Trend, regional variation and socioeconomic inequality in cardiovascular disease among the elderly population in China: evidence from a nationwide longitudinal study during 2011–2018

“…Such initiatives can empower individuals to adopt healthier lifestyles, cultivate cardiovascular wellness and mitigate the risk factors associated with CVD and its comorbidities 38 39. Different from other countries such as Canada, our study reveals a notable gender difference in CVD prevalence, with a higher incidence observed among women than men among individuals aged ≥60 years 10. This difference highlights the significance of considering unique population characteristics and healthcare contexts in CVD research.…”

Spatiotemporal analysis of regional TIA trends

“…By contrast, physical activity was similar across the regions and not a contributor to the high risk of stroke in South Eastern USA ( 14 ). In Canada, isolated hot spot exists in rural Canada rather than stroke belt phenomenon ( 9 ). A consistent theme is the association of stroke among regions with lower socioeconomic group even though the distribution of socioeconomic groups has remained stable ( 9 ).…”

“…In Canada, isolated hot spot exists in rural Canada rather than stroke belt phenomenon ( 9 ). A consistent theme is the association of stroke among regions with lower socioeconomic group even though the distribution of socioeconomic groups has remained stable ( 9 ). In Denmark, stroke and heart disease rates are higher on the Eastern part of Zealand than Eastern part of Jutland ( 28 ).…”

“…To plan and ensure fair health care access for all, we need to evaluate if the TIA incidence is different at a regional level (hot spots) and if these geographical patterns change over time and if prevention program needs to be designed for the region given that region's attributes ( 9 ). Papers and maps focussing on TIA and stroke prevalence and state of stroke services across the globe are available but focussed works on regional data in Australia for TIA is not available ( 10 – 12 ).…”

Neighborhood Characteristics Associated with Running in Metro Vancouver: A Preliminary Analysis

“…Running regularly is associated with reduced risk of cardiovascular disease, type 2 diabetes, and obesity [ 10 , 11 , 12 , 13 ]. At the same time that recreational running is increasing [ 6 , 14 ], so is sedentary behavior [ 15 , 16 , 17 , 18 ], which has the potential to undo benefits from running. Therefore, health initiatives have identified recreational running as an effective means to promote active populations and lower risks associated with physical inactivity [ 14 , 19 , 20 , 21 ].…”