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Is area-level socioeconomic deprivation associated with mortality due to circulatory system diseases in Poland?

BACKGROUND: Socioeconomic deprivation (SED) is known to influence cardiovascular health. However, studies analyzing the relationship between deprivation and circulatory system diseases (CSD) in Central and Eastern Europe are limited. This study aimed to assess the relationship between SED and mortal...

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Autores principales: Jamiołkowski, Jacek, Genowska, Agnieszka, Pająk, Andrzej
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9809142/
https://www.ncbi.nlm.nih.gov/pubmed/36597073
http://dx.doi.org/10.1186/s12889-022-14914-y
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author Jamiołkowski, Jacek
Genowska, Agnieszka
Pająk, Andrzej
author_facet Jamiołkowski, Jacek
Genowska, Agnieszka
Pająk, Andrzej
author_sort Jamiołkowski, Jacek
collection PubMed
description BACKGROUND: Socioeconomic deprivation (SED) is known to influence cardiovascular health. However, studies analyzing the relationship between deprivation and circulatory system diseases (CSD) in Central and Eastern Europe are limited. This study aimed to assess the relationship between SED and mortality due to CSD at a population level in 66 sub-regions of Poland. METHODS: The 2010–2014 data regarding mortality and SED components were obtained from the Central Statistical Office. An area-based SED index was calculated based on the higher education rates, employment structure, wages, unemployment, and poverty. The dynamics of changes in mortality due to CSD was expressed by the number of deaths prevented or postponed (DPP) in terciles of the SED index. The associations between the mortality from CSD and SED index were analyzed using multivariate Poisson regression models and generalized estimating equations. RESULTS: Among men, the percentage of DPP in 2014 was 13.1% for CSD, 23.4% for ischemic heart disease (IHD), and 21.4% for cerebrovascular diseases (CeVD). In the case of women, the proportion of DPP was 12.8, 25.6, and 21.6%, respectively. More deprived sub-regions experienced a greater decrease in CSD-related mortality than less deprived sub-regions. The disparity in mortality reduction between more deprived and less deprived sub-regions was even more pronounced for women. After adjusting for smoking prevalence, average BMI, population density, and changes in mortality over time, it was found that the SED index over the 2010–2014 time period was significantly associated with CSD- and IHD-related mortality for men (respectively 5.3 and 19.5% expected mortality increase per 1-unit increase of SED index), and with IHD- and CeVD-related mortality for women (respectively 30.3 and 23.0% expected mortality increase per 1-unit increase of SED index). CONCLUSIONS: Significant differences in mortality changes due to CSD in Poland could be observed in relation to socioeconomic deprivation, resulting in reduced health inequalities. To reduce CSD mortality, more comprehensive preventive measures, including approaches addressing the socioeconomic factors, mainly poverty, education and employment, are needed, particularly in less urbanized areas. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-022-14914-y.
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spelling pubmed-98091422023-01-04 Is area-level socioeconomic deprivation associated with mortality due to circulatory system diseases in Poland? Jamiołkowski, Jacek Genowska, Agnieszka Pająk, Andrzej BMC Public Health Research BACKGROUND: Socioeconomic deprivation (SED) is known to influence cardiovascular health. However, studies analyzing the relationship between deprivation and circulatory system diseases (CSD) in Central and Eastern Europe are limited. This study aimed to assess the relationship between SED and mortality due to CSD at a population level in 66 sub-regions of Poland. METHODS: The 2010–2014 data regarding mortality and SED components were obtained from the Central Statistical Office. An area-based SED index was calculated based on the higher education rates, employment structure, wages, unemployment, and poverty. The dynamics of changes in mortality due to CSD was expressed by the number of deaths prevented or postponed (DPP) in terciles of the SED index. The associations between the mortality from CSD and SED index were analyzed using multivariate Poisson regression models and generalized estimating equations. RESULTS: Among men, the percentage of DPP in 2014 was 13.1% for CSD, 23.4% for ischemic heart disease (IHD), and 21.4% for cerebrovascular diseases (CeVD). In the case of women, the proportion of DPP was 12.8, 25.6, and 21.6%, respectively. More deprived sub-regions experienced a greater decrease in CSD-related mortality than less deprived sub-regions. The disparity in mortality reduction between more deprived and less deprived sub-regions was even more pronounced for women. After adjusting for smoking prevalence, average BMI, population density, and changes in mortality over time, it was found that the SED index over the 2010–2014 time period was significantly associated with CSD- and IHD-related mortality for men (respectively 5.3 and 19.5% expected mortality increase per 1-unit increase of SED index), and with IHD- and CeVD-related mortality for women (respectively 30.3 and 23.0% expected mortality increase per 1-unit increase of SED index). CONCLUSIONS: Significant differences in mortality changes due to CSD in Poland could be observed in relation to socioeconomic deprivation, resulting in reduced health inequalities. To reduce CSD mortality, more comprehensive preventive measures, including approaches addressing the socioeconomic factors, mainly poverty, education and employment, are needed, particularly in less urbanized areas. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-022-14914-y. BioMed Central 2023-01-03 /pmc/articles/PMC9809142/ /pubmed/36597073 http://dx.doi.org/10.1186/s12889-022-14914-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Jamiołkowski, Jacek
Genowska, Agnieszka
Pająk, Andrzej
Is area-level socioeconomic deprivation associated with mortality due to circulatory system diseases in Poland?
title Is area-level socioeconomic deprivation associated with mortality due to circulatory system diseases in Poland?
title_full Is area-level socioeconomic deprivation associated with mortality due to circulatory system diseases in Poland?
title_fullStr Is area-level socioeconomic deprivation associated with mortality due to circulatory system diseases in Poland?
title_full_unstemmed Is area-level socioeconomic deprivation associated with mortality due to circulatory system diseases in Poland?
title_short Is area-level socioeconomic deprivation associated with mortality due to circulatory system diseases in Poland?
title_sort is area-level socioeconomic deprivation associated with mortality due to circulatory system diseases in poland?
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9809142/
https://www.ncbi.nlm.nih.gov/pubmed/36597073
http://dx.doi.org/10.1186/s12889-022-14914-y
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