Social inequalities in cardiovascular mortality in Spain from an intersectional perspective

Ideal cardiovascular health at ELSA-Brasil: non-additivity effects of gender, race, and schooling by using additive and multiplicative interactions

“…The normality of ICH distribution was tested using the Shapiro-Wilk test. Multiplicative and additive interaction analyses 12,29,30,31,32 were explored to incorporate an intersectionality perspective in the ICH assessment 19 , considering gender, race, and schooling level.…”

“…Several other studies indicate that women are more vulnerable to the effects of risk factors and to a low socioeconomic status, which partly explains the greater health inequality that can contribute to the persistence of cardiovascular diseases. Women usually have higher workload than men (unpaid work at home, besides their regular job) as well as greater job insecurity, lower wages, fewer leadership positions, and more work in secondary jobs, or lower access to quality health care 30,50 . Significant associations between work-family conflicts and ideal ICH were identified using ELSA-Brasil data, with ICH scores significantly lower for women considering the health behaviors with frequent interference in family-based work, frequent family interference based on work, and a frequent lack of time for personal care and leisure 51 .…”

Guía de práctica clínica de la Sociedad Interamericana de Cardiología sobre prevención primaria de enfermedad cardiovascular en la mujer

“…Por otro lado, el NE y nivel de ingreso bajos predicen morbimortalidad CV tras un IAM 187 , 188 y es más frecuente que la mujer tenga condiciones que determinan una salud más precaria, como un menor NE, menores salarios y mayor trabajo no remunerado, lo que las convierte en un grupo más vulnerable 189 , 190 .…”

“…Se ha observado que un apoyo social insuficiente y un bajo NSE aumentan 1.5 a 2 veces en el riesgo de ECV en mujeres 183 , 184 , 187 .…”

“…El NE y/o el NSE están inversamente relacionados con el RCV. En un estudio poblacional español el bajo NE se asoció con un riesgo incrementado de 1.88 en mujeres y 1.44 en hombres para muerte CV, CI, IC y ACV 187 . En el análisis de 819 mujeres del estudio WISE (Women’s Ischemia Syndrome Evaluation) el bajo NSE predijo muerte CV e IAM y mayor número de hospitalizaciones (p = 0.0001) 188 .…”