Educational inequalities in cardiovascular risk factor and blood pressure control in the elderly comparison of mesa cohort and chilean NHS survey outcome measures
Author
dc.contributor.author
Nazzal Nazal, Carolina
Author
dc.contributor.author
Shea, Steven
Author
dc.contributor.author
Castro Diehl, Cecilia
Author
dc.contributor.author
Alfaro Morgado, Tania
Author
dc.contributor.author
Frenz, Patricia
Author
dc.contributor.author
Rodríguez, Carlos J.
Admission date
dc.date.accessioned
2018-07-23T16:56:03Z
Available date
dc.date.available
2018-07-23T16:56:03Z
Publication date
dc.date.issued
2018
Cita de ítem
dc.identifier.citation
Global Heart, Vol 13, No. 1, 2018: 19-26
es_ES
Identifier
dc.identifier.other
10.1016/j.gheart.2017.09.001
Identifier
dc.identifier.uri
https://repositorio.uchile.cl/handle/2250/150154
Abstract
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Background: Social determinants differ between countries, which is not always considered when adapting health policies and interventions to face inequalities in noncommunicable diseases and their risk factors.
Objectives: The study sought to analyze educational inequalities in controlled blood pressure (CBP), obesity, and smoking in study populations from Chile and the United States in 2 periods, both countries with large social inequalities.
Methods: The study used data from the first and fifth waves of the MESA (Multiethnic Study of Atherosclerosis) cohort, and the 2003 and 2009 to 2010 Chilean National Health Survey (CNHS) survey outcome measures. The study compared cardiovascular risk factors prevalence as well as relative index of inequality (RII) and slope index of inequality (SII) between the 2 samples.
Results: In the CNHS 67.9% and 52.6% of participants had below primary education in 2003 and 2009 to 2010, respectively, compared with 12.3% and 8.1% in the first and fifth waves of the MESA study, respectively. Smoking prevalence was higher and increased in the CNHS compared with the MESA study, concentrated in better-educated women in both years (RII: 0.34; 95% confidence interval [CI]: 0.17 to 0.68; and RII: 0.55; 95% CI: 0.34 to 0.89, respectively). In contrast, smoking decreased over time in the MESA study in all socioeconomic strata, although relative inequalities increased in both sexes (for women, RII: 2.32; 95% CI 1.36 to 3.97; for men, RII: 3.34; 95% CI 2.04 to 5.47). CBP prevalence in both periods was higher in the first and fifth waves of the MESA study (69.7% and 80.2%) compared with the 2003 and 2009 to 2010 CNHS samples (34.2% and 52.3%), but only for the MESA study RII, favoring the better educated, was it significant in both periods and sexes. Obesity inequalities for Chilean women decreased slightly between 2003 and 2009 as prevalence grew in the most educated (RII: 2.21 to 1.68; SII: 0.29 to 0.22, respectively); conversely, they increased for both sexes in the MESA study.
Conclusions: The study findings confirm that patterns and trends in prevalence, and absolute and relative inequalities vary by country, suggesting that context and cultural issues matters.
es_ES
Patrocinador
dc.description.sponsorship
Columbia University
National Heart, Lung, and Blood Institute
N01-HC-95159
N01-HC-95160
N01-HC-95161
N01-HC-95162
N01-HC-95163
N01-HC-95164
N01-HC-95165
N01-HC-95166
N01-HC-95167
N01-HC-95168
N01-HC-95169
National Center for Research Resources
UL1-TR-000040
UL1-TR-001079
Educational inequalities in cardiovascular risk factor and blood pressure control in the elderly comparison of mesa cohort and chilean NHS survey outcome measures