Variation in coronary risk factors by social status: results from the Scottish Heart Health Study

Abstract

The relationship between social status and coronary heart disease in the United Kingdom is well established with the more socially disadvantaged being at higher risk. There is also evidence that the levels of most of the known coronary risk factors vary with social status in a way consistent with their relationship to coronary heart disease. Using data from the Scottish heart health study the aim of this study was to quantify, for men and women, the variation in four of the main coronary heart disease risk factors--smoking, serum total cholesterol level, blood pressure and obesity--according to a number of social factors--occupational social class, housing tenure, level of education and employment status. The analyses used both mean risk factor levels as well as the percentages above suggested cut off levels, in order to provide estimates of the percentage of people at risk. All the risk factors, apart from total cholesterol level in men, showed fairly consistent variation across social groups with the more socially disadvantaged being at higher risk. Similar social variation was found for the percentages above the cut off levels, and these indicate that nearly 60% of the Scottish population aged 40-59 years, have one or more risk factors for coronary heart disease. These results suggest that some targeting of health education and management is appropriate, and this is especially relevant as the reforms to the National Health Service set health targets for health authorities and encourage general practitioners to provide health promotion services.(ABSTRACT TRUNCATED AT 250 WORDS)