Relationship of different measures of socioeconomic status with cardiovascular disease risk factors and lifestyle in a New Zealand workforce survey

Abstract

Aims: To compare cardiovascular disease (CVD) risk factor levels of men and women in a local workforce with measures of socioeconomic (SES) status.

Methods: Participants were from a cross-sectional health screening survey of a multiracial workforce carried out between May 1988 and April 1990. 5677 Maori, Pacific Island, and Other workers (comprising 4108 men and 1569 women) aged 40 to 78 years participated. SES measures included the New Zealand Socioeconomic Index (NZSEI), combined household income, and level of education.

Results: In general, all SES status measures showed higher mean body mass index levels and waist-to-hip ratios, higher odds of cigarette smoking, and lower stature in the lower SES strata compared to the highest SES stratum. Both income and education showed higher 5-year CVD risks and lower leisure time physical activity levels in the lower SES strata compared to the highest. The odds of raised blood pressure were highest in people with no tertiary education compared to those with a university education. Lower income groups had higher fasting and 2-hour glucose levels, higher urinary albumin excretion, and an almost 2-fold odds of diabetes mellitus compared to the highest income group.

Conclusions: There was a trend to a more adverse pattern of CVD risk factor levels in the lower SES groups. The strongest associations were related to income and education rather than the NZSEI. Raised blood pressure was associated with education, and prevalence of diabetes mellitus with income. An increased living standard, more resources for primary health care, and health promotion targeting the community level should be beneficial. Effective strategies for reducing the risk level among deprived groups are needed to minimise the adverse social gradient in CVD risk factors.