Infant mortality, childhood nutrition, and ischaemic heart disease in England and Wales.

The measurement of effort-reward imbalance at work: European comparisons.

Despite recent declines in mortality, cardiovascular diseases are the leading cause of death in the United States today. It appears that many of the major risk factors for coronary disease have been identified. Researchers are still learning about different modifiable factors that may influence cardiovascular diseases. Socioeconomic status may provide a new focus. The principal measures of SES have been education, occupation, and income or combinations of these. Education has been the most frequent measure because it does not usually change (as occupation or income might) after young adulthood, information about education can be obtained easily, and it is unlikely that poor health in adulthood influences level of education. However, other measures of SES have merit, and the most informative strategy would incorporate multiple indicators of SES. A variety of psychosocial measures--for example, certain aspects of occupational status--may be important mediators of SES and disease. The hypothesis that high job strain may adversely affect health status has a rational basis and is supported by evidence from a limited number of studies. There is a considerable body of evidence for a relation between socioeconomic factors and all-cause mortality. These findings have been replicated repeatedly for 80 years across measures of socioeconomic level and in geographically diverse populations. During 40 years of study there has been a consistent inverse relation between cardiovascular disease, primarily coronary heart disease, and many of the indicators of SES. Evidence for this relation has been derived from prevalence, prospective, and retrospective cohort studies. Of particular importance to the hypothesis that SES is a risk factor for cardiovascular disease was the finding by several investigators that the patterns of association of SES with coronary disease had changed in men during the past 30 to 40 years and that SES has been associated with the decline of coronary mortality since the mid-1960s. However, the declines in coronary mortality of the last few decades have not affected all segments of society equally. There is some evidence that areas with the poorest socioenvironmental conditions experience later onset in the decline in cardiovascular mortality. A number of studies suggest that poor living conditions in childhood and adolescence contribute to increased risk of arteriosclerosis. Some of these studies have been criticized because of their nature, and others for inadequate control of confounding factors.(ABSTRACT TRUNCATED AT 400 WORDS)

Socioeconomic factors and cardiovascular disease: a review of the literature.

Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians.

https://repub.eur.nl/pub/11465/OnTheMeasurementOfInequalities_1991.pdf

On the measurement of inequalities in health

Lessons from the study of immigrant mortality

Analysis of mortality trends over 40 years in England and Wales showed that mortality from coronary heart disease had become progressively more common in working-class men and women than in those from the middle and upper classes. The change was most noticeable for men. Whereas in 1931 and 1951 heart disease was more common in men of social classes I and II, by 1961 it was more common in men of classes IV and V. This change in social-class distribution can only partly be explained by changes in diagnostic methods. The worsening mortality of classes IV and V correlated with relatively more smoking, a higher consumption of sugar, and a lower consumption of wholemeal bread in these classes. There was no correlation between change in heart disease and change in the social-class pattern of fat consumption.

https://www.bmj.com/content/bmj/2/6145/1109.full.pdf

Changing social-class distribution of heart disease.

Diet and risk factors for coronary heart disease in asians in northwest london

Comparison of mortality of Irish immigrants in England and Wales with that of Irish and British nationals.

The Office of Population Censuses and Surveys (OPCS) is analysing mortality of immigrants to England and Wales. On average, immigrants are healthier and have a lower mortality then people who remained in the country of origin—demonstrating the ‘selection’ effect of migration. For cardiovascular diseases, the mortality of immigrants reflects the pattern in the country from which they came. Thus, immigrants to England and Wales from France, Spain and Italy (low-rate countries) have a low standardized mortality ratio from ischaemic heart disease. Immigrants from the West Indies and Africa have a high mortality from hypertension and cerebrovascular disease. It is noted that the mortality from ischaemic heart disease is high among immigrants from India and Pakistan.

https://pmj.bmj.com/content/postgradmedj/57/674/760.full.pdf

A.M. Adelstein

Papers

Lessons from the study of immigrant mortality

Changing social-class distribution of heart disease.

Diet and risk factors for coronary heart disease in asians in northwest london

Comparison of mortality of Irish immigrants in England and Wales with that of Irish and British nationals.

Cardiovascular mortality among immigrants to england and wales