RESEARCH REPORT
Socioeconomic status, status inconsistency and risk of ischaemic heart disease: a prospective study among members of a statutory health insurance company
1 Working Group Medical Sociology, Institute of Epidemiology, University of Ulm, Ulm, Germany
2 Institute of Epidemiology, University of Ulm, Ulm, Germany
3 Medical Sociology Unit, Hannover Medical School, Hannover, Germany
Correspondence to:
Correspondence to:
Dr R Peter
Department of Epidemiology, University of Ulm, Helmholtzstrasse 22, DE-89081 Ulm, Germany; richard.peter{at}uni-ulm.de
Background: Inconsistency in social status and its impact on health have been a focus of research 30–40 years ago. Yet, there is little recent information on it’s association with ischaemic heart disease (IHD) morbidity and IHD is still defined as one of the major health problems in socioeconomically developed societies.
Methods: A secondary analysis of prospective historical data from 68 805 male and female members of a statutory German health insurance company aged 25–65 years was conducted. Data included information on sociodemographic variables, social status indicators (education, occupational grade and income) and hospital admissions because of IHD.
Results: Findings from Cox regression analysis showed an increased risk for IHD in the group with the highest educational level, whereas the lowest occupational and income groups had the highest hazard ratio (HR). Further analysis revealed that after adjustment for income status inconsistency (defined by the combination of higher educational level with lower occupational status) accounts for increased risk of IHD (HR for men, 3.14 and for women, 3.63). An association of similar strength was observed regarding high education/low income in women (HR 3.53). The combination of low education with high income reduced the risk among men (HR 0.29). No respective findings were observed concerning occupational group and income.
Conclusions: Status inconsistency is associated with the risk of IHD as well as single traditional indicators of socioeconomic position. Information on status inconsistency should be measured in addition to single indicators of socioeconomic status to achieve a more appropriate estimation of the risk of IHD.
Abbreviations: ICD, International Classification of Diseases; IHD, ischaemic heart disease; SES, socioeconomic status
Relevant Article
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
J Epidemiol Community Health 2007 61: 561.
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
