Differences in mortality from Ischemic Heart Disease by marital status and social class

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Abstract

IHD mortality and psychosocial factors were studied by analyzing IHD mortality rates, by marital status and social class simultaneously. Standardized death rates were calculated for all IHD deaths (32,433) in Finland among 25–84-yr-olds during a 3-yr period. The reliability of the IHD diagnostics was evaluated by studying autopsy rates, criteria for the IHD diagnosis, the proportional mortality rate of IHD with respect to other heart diseases and total disease mortality, and geographical factors. In different marital-status-social-class combinations, the proportion of deaths from IHD was highest when total disease mortality was lowest. The variation with marital status or social class, separately, was less than when both factors were analyzed simultaneously. The highest IHD mortality was concentrated among widowed and divorced unskilled workers, the differences between marital status and social class being most marked (3.3-fold) for men aged 25–54. Divorced and widowed persons seemed to have a higher risk of sudden death than married persons. The Finnish east-west difference in IHD mortality accentuated differences by marital status and social class, in particular a high-risk group—widowed unskilled workers—having a seven-fold mortality risk compared to the whole of North Karelia, an area of high IHD mortality.

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