Titre :
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Increasing inequalities in all-cause and cardiovascular mortality among US adults aged 25-64 years by area socioeconomic status, 1969-1998. (2002)
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Auteurs :
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Gopal-K SINGH ;
Mohammad SIAHPUSH
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Type de document :
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Article
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Dans :
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International journal of epidemiology (vol. 31, n° 3, 2002)
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Pagination :
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600-613
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Langues:
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Anglais
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Mots-clés :
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Adulte
;
Homme
;
Etats Unis
;
Amérique
;
Facteur socioéconomique
;
Mortalité
;
Appareil circulatoire [pathologie]
;
Epidémiologie
;
Facteur risque
;
Amérique du Nord
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Résumé :
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[BDSP. Notice produite par INIST-CNRS GBR0xAf1. Diffusion soumise à autorisation]. Background This study examined the extent to which areal socio-economic gradients in all-cause and cardiovascular disease (CVD) mortality among US men and women aged 25-64 years increased between 1969 and 1998. Methods Using factor analysis 17 census tract variables were used to develop an areal index of socio-economic status that was used to stratify all US counties into five socio-economic categories. By linking the index to county-level mortality data from 1969 to 1998, we calculated annual age-adjusted mortality rates for each area socio-economic group. Poisson regression models were fitted to estimate areal socio-economic gradients in mortality over time. Results Areal socio-economic gradients in all-cause and cardiovascular mortality have increased substantially over the past three decades. Compared to men in the highest area socio-economic group, rates of all-cause and CVD mortality among men in the lowest area socio-economic group were 42% and 30% greater in 1969-1970 and 73% and 79% greater in 1997-1998, respectively. The gradients in mortality among women were steeper for CVD than for all causes. Compared to women in the highest area socio-economic group, rates of all-cause and CVD mortality among women in the lowest area socio-economic group were 29% and 49% greater in 1969-1970 and 53% and 94% greater in 1997-1998, respectively. Conclusions Although US all-cause and cardiovascular mortality declined for all area socio-economic groups during 1969-1998, the gradient increased because of significantly larger mortality declines in the higher socio-economic groups. Increasing areal inequalities in mortality shown here may be related to increasing temporal differences in the material and social living conditions between areas.
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