Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 7:17:200184.
doi: 10.1016/j.ijcrp.2023.200184. eCollection 2023 Jun.

Socioeconomic determinants of health, traditional risk factors and cardiovascular outcomes in Australia

Rahul G Muthalaly  1   2 , Adam J Nelson  2 , Arul Baradi  1 , Ojas H Mehta  1 , Andrew M Wilson  1   3 , Arthur Nasis  1   2
Affiliations

Socioeconomic determinants of health, traditional risk factors and cardiovascular outcomes in Australia

Rahul G Muthalaly et al. Int J Cardiol Cardiovasc Risk Prev. .

Abstract

Background: Cardiovascular disease burden is decreasing, but these reductions have not been distributed equally amongst socioeconomic groups.

Objectives: The aim of this study was to define the relationships between different domains of socioeconomic health, traditional cardiovascular risk factors and cardiovascular events.

Methods: This was a cross-sectional study of local government areas (LGAs) in Victoria, Australia. We used data from a population health survey combined with cardiovascular event data derived from hospital and government data. Four socioeconomic domains: educational attainment, financial wellbeing, remoteness, and psychosocial health, were generated from 22 variables. The primary outcome was a composite of non-STEMI, STEMI, heart failure and cardiovascular deaths per 10,000 persons. Linear regression and cluster analysis were used to assess the relationships between risk factors and events.

Results: Across 79 LGAs there were 33,654 interviews conducted. All socioeconomic domains were associated with burden of traditional risk factors, including hypertension, smoking, poor diet, diabetes, and obesity. Financial wellbeing, educational attainment and remoteness were all correlated with cardiovascular events on univariate analysis. After multivariate adjustment for age and sex, financial wellbeing, psychosocial wellbeing, and remoteness were associated with cardiovascular events, while educational attainment was not. After including traditional risk factors only financial wellbeing and remoteness remained correlated with cardiovascular events.

Conclusions: Financial wellbeing and remoteness independently be associated with cardiovascular events, while educational attainment and psychosocial wellbeing are attenuated by traditional cardiovascular risk factors. Poor socioeconomic health is clustered in certain areas, which have high cardiovascular event rates.

Keywords: Coronary artery disease; Delivery of health care; Epidemiology; Heart failure; Risk factors.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
–Bar graphs of socioeconomic variables and cardiovascular outcomes.
Fig. 2
Fig. 2
Heatmaps of cardiovascular outcomes, financial wellbeing, education levels and psychosocial wellbeing by LGA.
Fig. 3
Fig. 3
Geographical distribution of clusters of socioeconomic health.
See this image and copyright information in PMC

References

    1. Trends in Cardiovascular Deaths. Australian Institute of Health and Welfare; Canberra: 2017.
    1. Kavanagh A., Bentley R.J., Turrell G., Shaw J., Dunstan D., Subramanian S.V. Socioeconomic position, gender, health behaviours and biomarkers of cardiovascular disease and diabetes. Soc. Sci. Med. 2010;71(6):1150–1160. - PubMed
    1. Brown A. Addressing cardiovascular inequalities among indigenous Australians. Global. Cardiology. Science. and. Practice. 2012;2012(1) - PMC - PubMed
    1. Schultz W.M., Kelli H.M., Lisko J.C., et al. Socioeconomic status and cardiovascular outcomes: challenges and interventions. Circulation. 2018;137(20):2166–2178. - PMC - PubMed
    1. The Economic Costs of Obesity: Report for Diabetes Australia. Canberra Access Economics; 2006.

LinkOut - more resources