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Lookup NU author(s): Professor Sheena Ramsay
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
Background Evidence from longitudinal studies on the influence of neighbourhood socioeconomic factors in older age on cardiovascular disease (CVD) mortality is limited. We aimed to investigate the prospective association of neighbourhood-level deprivation in later life with CVD mortality, and assess the underlying role of established cardiovascular risk factors. Methods A socially representative cohort of 3924 men, aged 60-79 years in 1998-2000, from 24 British towns, was followed up until 2012 for CVD mortality. Quintiles of the national Index of Multiple Deprivation (IMD), a composite score of neighbourhood-level factors (including income, employment, education, housing and living environment) were used. Multilevel logistic regression with discrete-time models (stratifying followup time into months) were used. Results Over 12 years, 1545 deaths occurred, including 580 from CVD. The risk of CVD mortality showed a graded increase from IMD quintile 1 (least deprived) to 5 (most deprived). Compared to quintile 1, the ageadjusted odds of CVD mortality in quintile 5 were 1.71 (95% CI 1.32 to 2.21), and 1.62 (95% CI 1.23 to 2.13) on further adjustment for individual social class, which was attenuated slightly to 1.44 (95% CI 1.09 to 1.89), but remained statistically significant after adjustment for smoking, body mass index, physical activity and use of alcohol. Further adjustment for blood pressure, highdensity lipoprotein cholesterol and prevalent diabetes made little difference. Conclusions Neighbourhood-level deprivation was associated with an increased risk of CVD mortality in older people independent of individual-level social class and cardiovascular risk factors. The role of other specific neighbourhood-level factors merits further research.
Author(s): Ramsay SE, Morris RW, Whincup PH, Subramanian SV, Papacosta AO, Lennon LT, Wannamethee SG
Publication type: Article
Publication status: Published
Journal: Journal of Epidemiology and Community Health
Year: 2015
Volume: 69
Issue: 12
Pages: 1224-1231
Print publication date: 01/12/2015
Online publication date: 18/08/2015
Acceptance date: 14/07/2015
Date deposited: 14/06/2017
ISSN (print): 0143-005X
ISSN (electronic): 1470-2738
Publisher: BMJ Publishing Group
URL: https://doi.org/10.1136/jech-2015-205542
DOI: 10.1136/jech-2015-205542
PubMed id: 26285580
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