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The influence of neighbourhood-level socioeconomic deprivation on cardiovascular disease mortality in older age: Longitudinal multilevel analyses from a cohort of older British men

Lookup NU author(s): Dr Sheena Ramsay

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

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.


Publication metadata

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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Funding

Funder referenceFunder name
G1002391
RG/08/013/25942

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