Socioeconomic Status and Cardiovascular Outcomes

Schultz, William W.; Kelli, Heval Mohamed; Lisko, John; Varghese, Tina; Shen, Jia; Sandesara, Pratik B.; Quyyumi, Arshed A.; Taylor, Herman A.; Gulati, Martha; Harold, John; Mieres, Jennifer H.; Ferdinand, Keith C.; Mensah, George A.; Sperling, Laurence

doi:10.1161/circulationaha.117.029652

Cited by 815 publications

(646 citation statements)

References 114 publications

Supporting

Mentioning

598

Contrasting

Unclassified

Order By: Relevance

“…People living in lower SEP areas may also be more restricted to accessing the resources in closer geographical proximity compared with those in higher SEP areas due to many factors including lower rates of car ownership and poorer public transport, particularly in some regional and rural areas . Although it is well established that individual level socio‐economic disadvantage is associated with poorer health outcomes, including obesity, the “deprivation amplification” theory explains how disadvantages at an individual level may be amplified by living in a disadvantaged area.…”

Section: Discussionmentioning

confidence: 99%

Variation in the physical activity environment according to area‐level socio‐economic position—A systematic review

et al. 2019

View full text Add to dashboard Cite

Summary Physical inactivity is a major contributing factor to obesity, and both follow a socio‐economic gradient. This systematic review aims to identify whether the physical activity environment varies by socio‐economic position (SEP), which may contribute to socio‐economic patterning of physical activity behaviours, and in turn, obesity levels. Six databases were searched. Studies were included if they compared an objectively measured aspect of the physical activity environment between areas of differing SEP in a high‐income country. Two independent reviewers screened all papers. Results were classified according to the physical activity environment analysed: walkability/bikeability, green space, and recreational facilities. Fifty‐nine studies met the inclusion criteria. A greater number of positive compared with negative associations were found between SEP and green space, whereas there were marginally more negative than positive associations between SEP and walkability/bikeability and recreational facilities. A high number of mixed and null results were found across all categories. With a high number of mixed and null results, clear socio‐economic patterning in the presence of physical activity environments in high‐income countries was not evident in this systematic review. Heterogeneity across studies in the measures used for both SEP and physical activity environments may have contributed to this result.

show abstract

Section: Discussionmentioning

confidence: 99%

Variation in the physical activity environment according to area‐level socio‐economic position—A systematic review

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Accumulating evidence supports the concept that low socioeconomic status (SES) is emerging as a contributor to all-cause mortality and cardiovascular risk and that it is equivalent to traditional risk factors. 1 This increased cardiovascular disease (CVD) risk may be mediated by behavioral, psychological, social and biological risk factors that are more prevalent in low SES individuals, and even disparities in standards of patient care. 1,2 Increased cardiorespiratory fitness (CRF) has been shown to lower CVD risk and all-cause mortality independent of other risk factors, race and gender in high-risk populations.…”

mentioning

confidence: 99%

Fitness for Richer, for Poorer

Kokkinos

Myers

2020

European Journal of Preventive Cardiology

View full text Add to dashboard Cite

Accumulating evidence supports the concept that low socioeconomic status (SES) is emerging as a contributor to all-cause mortality and cardiovascular risk and that it is equivalent to traditional risk factors. 1 This increased cardiovascular disease (CVD) risk may be mediated by behavioral, psychological, social and biological risk factors that are more prevalent in low SES individuals, and even disparities in standards of patient care. 1,2 Increased cardiorespiratory fitness (CRF) has been shown to lower CVD risk and all-cause mortality independent of other risk factors, race and gender in high-risk populations. 3 Relatively lower levels of leisure time physical activity and CRF have been reported in low SES individuals as compared with those of high SES groups. 4 Previous studies have also reported that the low CRF levels in low SES individuals could in part explain the socioeconomic disparities in all-cause mortality. 5,6 Low leisure time physical activity may be fostered by lack of resources in socioeconomically deprived neighborhoods, such as the absence of sidewalks, fewer accessible recreational facilities, relatively unsafe outdoor exercise environments and reduced opportunities to engage in leisure time physical activity. 7 Longitudinal studies have demonstrated that neighborhoods with favorable physical activity environments are associated with increased individual and group physical activities and better cardiovascular risk profiles. 8,9 This suggests that the lower levels of physical activity observed among low SES groups is in part due to the built environment. By extension, the worse cardiovascular outcomes and higher mortality among lower SES groups may well be due in part to these environmental factors. In the study by Jae et al. 10 published in the current issue, the investigators sought to assess the independent and combined effects of CRF and SES in 2368 men, participants in the Kuopio Ischaemic Heart Disease Risk study. SES was determined by self-reported questionnaires by way of a summary index that combined measures of income, education, occupational prestige, material standard of living, and housing conditions. CRF was based on directly measured oxygen uptake (VO 2peak ), the most objective marker of CRF. Blood pressure, glucose and lipid levels, and body mass index were assessed.Risk factors including smoking, the presence of chronic disease, medications, and related demographic/lifestyle information were evaluated by standardized selfadministered questionnaires. Physical activity levels and estimated caloric expenditure (kcal/day) were also assessed using a 12-month physical activity history modified from the Minnesota leisure-time physical activity questionnaire. Although the investigators did not elaborate on the relevance of the latter data, it would have been of interest to do so.SES was inversely and independently associated with risks of all-cause mortality and CVD mortality. Directly measured peak oxygen uptake among low SES individuals was approximately 3.8 ml/kg/min lower compare...

show abstract

“…Individuals with low income are significantly less likely to successfully quit smoking than those who live at or above the federal poverty level (Harwood, Salsberry, Ferketich, & Wewers, 2007;Jamal et al, 2015). In addition, low income and SES are associated with increased likelihood of developing cardiovascular disease or diabetes, poorer mental health and poorer self-rated health, and lower life expectancy (Meyer, Castro-Schilo, & Aguilar-Gaxiola, 2014;Schultz et al, 2018).…”

mentioning

confidence: 99%

Quit Happens: A community clinic‐based, multitiered smoking cessation intervention

Shishani

Graves

McGowan

et al. 2019

Public Health Nursing

View full text Add to dashboard Cite

Objectives To evaluate the “Quit Happens” program launched to reduce tobacco use in low‐income populations in a federally qualified nonprofit health center with clinics in Washington and Idaho. Quit Happens was implemented in 2015 and involved a public health nurse, patient, provider, clinic, health system, and community components. Design and sample This smoking cessation program was assessed using a pre–post evaluation design. Nine clinics in a single system of federally qualified nonprofit health centers participated in this program. Intervention The Quit Happens program was implemented across nine clinics in Washington and Idaho. A specialized public health nurse led the tobacco cessation training of all clinic staff and assisted with development of the smoking cessation program. The 5A model was used as the framework for the training. Measurements The proportion of patients identifying as a current or former smoker was measured using data extracted from electronic health records. Results Declines in patient reports of currently smoking were observed between 2016 and 2018. The percent of current smokers identified in electronic health records decreased 18.7% and percent of former smokers doubled. Conclusion This community‐based tobacco cessation program had wide clinic and community support and self‐reported smoking behavior declined over time. A public health nurse's leadership in offering training and program development around tobacco cessation to a local community organization can contribute to reductions in smoking rates.

show abstract

Socioeconomic Status and Cardiovascular Outcomes

Cited by 815 publications

References 114 publications

Variation in the physical activity environment according to area‐level socio‐economic position—A systematic review

Variation in the physical activity environment according to area‐level socio‐economic position—A systematic review

Fitness for Richer, for Poorer

Quit Happens: A community clinic‐based, multitiered smoking cessation intervention

Contact Info

Product

Resources

About