Twelve-year (2008-2019) trends in socioeconomic inequalities in cardiovascular risk factors in a Swiss representative survey of the general population

Abstract

Objective: We assessed trends in socioeconomic inequalities in cardiovascular risk factors prevalence among Swiss adults from 2008 to 2019.

Methods: Using data from the Bus Santé study, an annual survey of adults living in Geneva, Switzerland, we calculated the prevalence per period and by demographic and socioeconomic indicators, assessing inequality trends using the relative index of inequality (RII) and the slope index of inequality (SII).

Results: Among 10,739 participants, most CVD risk factors decreased over time, while diabetes, obesity, and smoking prevalence remained steady. In 2017-2019, prevalence of most CVD risk factors was higher in socioeconomically disadvantaged groups. Relative and absolute inequalities decreased over time, but mostly remained, for hypertension [in 2017-2019, education-RII (95 % CI) = 1.27 (1.12-1.46), income-RII = 1.27 (1.10-1.47)], hypercholesterolemia [education-RII = 1.15 (1.00-1.32)], and sedentarity [education-RII = 1.95 (1.52-2.51), income-RII = 1.69 (1.28-2.23)], and appeared to have reversed for hazardous alcohol use [income-RII = 0.75 (0.60-0.93)]. Substantial and persistent relative and absolute inequalities in diabetes prevalence were observed [education-RII = 2.39 (1.75-3.27), income-RII = 3.18 (2.25-4.48), and subsidy-RII = 2.77 (1.89-4.05)]. Inequalities were also marked across all socioeconomic indicators for obesity prevalence [education-RII = 3.32 (2.63-4.19), income-RII = 2.37 (1.85-3.04), subsidy-RII = 1.98 (1.48-2.66)] and for smoking [education-RII = 2.42 (2.06-2.84), income-RII = 2.37 (1.99-2.84), subsidy-RII = 1.91 (1.56-2.35)].

Conclusions: Over 12 years in Geneva, Switzerland, socioeconomic inequalities in hypertension, hypercholesterolemia, hazardous alcohol use, and sedentarity decreased but persist, while substantial inequalities in diabetes, obesity, and smoking remained unchanged.

Keywords: Absolute inequalities; Cardiovascular risk factors; Diabetes; Hypercholesterolemia; Hypertension; Obesity; Population-based study; Relative inequalities; Sedentarity; Smoking; Trends in socioeconomic inequalities.

Fig. 1

Trends in relative socioeconomic inequalities in the prevalence of cardiovascular risk factors among adults residing in Geneva, Switzerland, Bus Santé 2008–2019 Relative index of inequalities and 95 % confidence intervals are from Poisson regressions with robust standard errors, adjusted for age, sex and survey period. P values for linear trend are from interaction term between the RII and survey period. Dotted line RII = 1.00 indicates no difference in prevalence between most disadvantaged and most privileged socioeconomic groups.

Fig. 2

Trends in absolute socioeconomic inequalities in the prevalence of cardiovascular risk factors among adults residing in Geneva, Switzerland, Bus Santé 2008–2019 Slope index of inequalities and 95 % confidence intervals are from linear regressions with robust standard errors, adjusted for age, sex and survey period. P values for linear trend are from interaction term between the SII and survey period. Dotted line SII = 0.00 indicates no difference in prevalence between most disadvantaged and most privileged socioeconomic groups.