Socioeconomic status and incidence of sudden cardiac arrest
Low socioeconomic status is associated with poor cardiovascular health. We evaluated the association between socioeconomic status and the incidence of sudden cardiac arrest, a condition that accounts for a substantial proportion of cardiovascular-related deaths, in seven large North American urban p...
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| Veröffentlicht in: | Canadian Medical Association journal (CMAJ) 2011-10, Vol.183 (15), p.1705-1712 |
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| creator | Reinier, Kyndaron Thomas, Elizabeth Andrusiek, Douglas L Aufderheide, Tom P Brooks, Steven C Callaway, Clifton W Pepe, Paul E Rea, Thomas D Schmicker, Robert H Vaillancourt, Christian Chugh, Sumeet S |
| description | Low socioeconomic status is associated with poor cardiovascular health. We evaluated the association between socioeconomic status and the incidence of sudden cardiac arrest, a condition that accounts for a substantial proportion of cardiovascular-related deaths, in seven large North American urban populations.
Using a population-based registry, we collected data on out-of-hospital sudden cardiac arrests occurring at home or at a residential institution from Apr. 1, 2006, to Mar. 31, 2007. We limited the analysis to cardiac arrests in seven metropolitan areas in the United States (Dallas, Texas; Pittsburgh, Pennsylvania; Portland, Oregon; and Seattle-King County, Washington) and Canada (Ottawa and Toronto, Ontario; and Vancouver, British Columbia). Each incident was linked to a census tract; tracts were classified into quartiles of median household income.
A total of 9235 sudden cardiac arrests were included in the analysis. For all sites combined, the incidence of sudden cardiac arrestin the lowest socioeconomic quartile was nearly double that in the highest quartile (incidence rate ratio [IRR] 1.9, 95% confidence interval [CI] 1.8-2.0). This disparity was greater among people less than 65 years old (IRR 2.7, 95% CI 2.5-3.0) than among those 65 or older (IRR 1.3, 95% CI 1.2-1.4). After adjustment for study site and for population age structure of each census tract, the disparity across socioeconomic quartiles for all ages combined was greater in the United States (IRR 2.0, 95% CI 1.9-2.2) than in Canada (IRR 1.8, 95% CI 1.6-2.0) (p |
| doi_str_mv | 10.1503/cmaj.101512 |
| format | Article |
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Using a population-based registry, we collected data on out-of-hospital sudden cardiac arrests occurring at home or at a residential institution from Apr. 1, 2006, to Mar. 31, 2007. We limited the analysis to cardiac arrests in seven metropolitan areas in the United States (Dallas, Texas; Pittsburgh, Pennsylvania; Portland, Oregon; and Seattle-King County, Washington) and Canada (Ottawa and Toronto, Ontario; and Vancouver, British Columbia). Each incident was linked to a census tract; tracts were classified into quartiles of median household income.
A total of 9235 sudden cardiac arrests were included in the analysis. For all sites combined, the incidence of sudden cardiac arrestin the lowest socioeconomic quartile was nearly double that in the highest quartile (incidence rate ratio [IRR] 1.9, 95% confidence interval [CI] 1.8-2.0). This disparity was greater among people less than 65 years old (IRR 2.7, 95% CI 2.5-3.0) than among those 65 or older (IRR 1.3, 95% CI 1.2-1.4). After adjustment for study site and for population age structure of each census tract, the disparity across socioeconomic quartiles for all ages combined was greater in the United States (IRR 2.0, 95% CI 1.9-2.2) than in Canada (IRR 1.8, 95% CI 1.6-2.0) (p<0.001 for interaction).
The incidence of sudden cardiac arrest at home or at a residential institution was higher in poorer neighbourhoods of the US and Canadian sites studied, although the association was attenuated in Canada. The disparity across socioeconomic quartiles was greatest among people younger than 65. The association between socioeconomic status and incidence of sudden cardiac arrest merits consideration in the development of strategies to improve survival from sudden cardiac arrest, and possibly to identify opportunities for prevention.</description><identifier>ISSN: 0820-3946</identifier><identifier>EISSN: 1488-2329</identifier><identifier>DOI: 10.1503/cmaj.101512</identifier><identifier>PMID: 21911550</identifier><identifier>CODEN: CMAJAX</identifier><language>eng</language><publisher>Canada: Joule Inc</publisher><subject>Age Distribution ; Aged ; Analysis ; Canada - epidemiology ; Cardiac arrest ; Care and treatment ; Death, Sudden, Cardiac - epidemiology ; Disease prevention ; Female ; Health Status Disparities ; Heart attacks ; Humans ; Incidence ; Income ; Male ; Middle Aged ; Poisson Distribution ; Registries ; Regression Analysis ; Risk factors ; Social Class ; Social classes ; Socioeconomic factors ; Studies ; United States - epidemiology ; Urban Health</subject><ispartof>Canadian Medical Association journal (CMAJ), 2011-10, Vol.183 (15), p.1705-1712</ispartof><rights>COPYRIGHT 2011 Joule Inc.</rights><rights>Copyright Canadian Medical Association Oct 18, 2011</rights><rights>1995-2011, Canadian Medical Association 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c704t-6aa644722aa27fb59f47389b2b9d69e99de8b112dc4c560ef8e708c026b8a71d3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3193117/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3193117/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21911550$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Reinier, Kyndaron</creatorcontrib><creatorcontrib>Thomas, Elizabeth</creatorcontrib><creatorcontrib>Andrusiek, Douglas L</creatorcontrib><creatorcontrib>Aufderheide, Tom P</creatorcontrib><creatorcontrib>Brooks, Steven C</creatorcontrib><creatorcontrib>Callaway, Clifton W</creatorcontrib><creatorcontrib>Pepe, Paul E</creatorcontrib><creatorcontrib>Rea, Thomas D</creatorcontrib><creatorcontrib>Schmicker, Robert H</creatorcontrib><creatorcontrib>Vaillancourt, Christian</creatorcontrib><creatorcontrib>Chugh, Sumeet S</creatorcontrib><creatorcontrib>Resuscitation Outcomes Consortium Investigators</creatorcontrib><creatorcontrib>the Resuscitation Outcomes Consortium Investigators</creatorcontrib><title>Socioeconomic status and incidence of sudden cardiac arrest</title><title>Canadian Medical Association journal (CMAJ)</title><addtitle>CMAJ</addtitle><description>Low socioeconomic status is associated with poor cardiovascular health. We evaluated the association between socioeconomic status and the incidence of sudden cardiac arrest, a condition that accounts for a substantial proportion of cardiovascular-related deaths, in seven large North American urban populations.
Using a population-based registry, we collected data on out-of-hospital sudden cardiac arrests occurring at home or at a residential institution from Apr. 1, 2006, to Mar. 31, 2007. We limited the analysis to cardiac arrests in seven metropolitan areas in the United States (Dallas, Texas; Pittsburgh, Pennsylvania; Portland, Oregon; and Seattle-King County, Washington) and Canada (Ottawa and Toronto, Ontario; and Vancouver, British Columbia). Each incident was linked to a census tract; tracts were classified into quartiles of median household income.
A total of 9235 sudden cardiac arrests were included in the analysis. For all sites combined, the incidence of sudden cardiac arrestin the lowest socioeconomic quartile was nearly double that in the highest quartile (incidence rate ratio [IRR] 1.9, 95% confidence interval [CI] 1.8-2.0). This disparity was greater among people less than 65 years old (IRR 2.7, 95% CI 2.5-3.0) than among those 65 or older (IRR 1.3, 95% CI 1.2-1.4). After adjustment for study site and for population age structure of each census tract, the disparity across socioeconomic quartiles for all ages combined was greater in the United States (IRR 2.0, 95% CI 1.9-2.2) than in Canada (IRR 1.8, 95% CI 1.6-2.0) (p<0.001 for interaction).
The incidence of sudden cardiac arrest at home or at a residential institution was higher in poorer neighbourhoods of the US and Canadian sites studied, although the association was attenuated in Canada. The disparity across socioeconomic quartiles was greatest among people younger than 65. The association between socioeconomic status and incidence of sudden cardiac arrest merits consideration in the development of strategies to improve survival from sudden cardiac arrest, and possibly to identify opportunities for prevention.</description><subject>Age Distribution</subject><subject>Aged</subject><subject>Analysis</subject><subject>Canada - epidemiology</subject><subject>Cardiac arrest</subject><subject>Care and treatment</subject><subject>Death, Sudden, Cardiac - epidemiology</subject><subject>Disease prevention</subject><subject>Female</subject><subject>Health Status Disparities</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Incidence</subject><subject>Income</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Poisson Distribution</subject><subject>Registries</subject><subject>Regression Analysis</subject><subject>Risk factors</subject><subject>Social Class</subject><subject>Social classes</subject><subject>Socioeconomic factors</subject><subject>Studies</subject><subject>United States - epidemiology</subject><subject>Urban Health</subject><issn>0820-3946</issn><issn>1488-2329</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqV0l2L1DAUBuAgijuuXnkvZRcUkY5J-pEGQVgWPxYWBVevw2lyOpOhk8wmrei_N2XWZSpzY3qR0jx5m3AOIc8ZXbKKFm_1FjZLRlnF-AOyYGXT5Lzg8iFZ0IbTvJBlfUKexLihaRRcPCYnnEnGqoouyLsbr61H7Z3fWp3FAYYxZuBMZp22Bp3GzHdZHE16zzQEY0FnEALG4Sl51EEf8dndfEp-fPzw_fJzfv3109XlxXWuBS2HvAaoy1JwDsBF11ayK0XRyJa30tQSpTTYtIxxo0td1RS7BgVtNOV124Bgpjgl7_e5u7HdotHohgC92gW7hfBbebBqvuLsWq38T1UwWTAmUsCru4Dgb8d0crW1UWPfg0M_RiVpJesJJnn2j9z4Mbh0OyU551SUnCd0vkcr6FFZ1_n0Vz1FqgsuaM0aVk5R-RG1QofpiN5hZ9PnmT874vXO3qpDtDyC0mMwle9o6uvZhmQG_DWsYIxRXd18-w_7ZW5fHtg1Qj-so-_HwXoX5_DNHurgYwzY3deNUTX1r5r6V-37N-kXh6W-t38btvgDcsXlQQ</recordid><startdate>20111018</startdate><enddate>20111018</enddate><creator>Reinier, Kyndaron</creator><creator>Thomas, Elizabeth</creator><creator>Andrusiek, Douglas L</creator><creator>Aufderheide, Tom P</creator><creator>Brooks, Steven C</creator><creator>Callaway, Clifton W</creator><creator>Pepe, Paul E</creator><creator>Rea, Thomas D</creator><creator>Schmicker, Robert H</creator><creator>Vaillancourt, Christian</creator><creator>Chugh, Sumeet S</creator><general>Joule Inc</general><general>CMA Impact, Inc</general><general>Canadian Medical Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ISN</scope><scope>ISR</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FQ</scope><scope>8FV</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M3G</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20111018</creationdate><title>Socioeconomic status and incidence of sudden cardiac arrest</title><author>Reinier, Kyndaron ; Thomas, Elizabeth ; Andrusiek, Douglas L ; Aufderheide, Tom P ; Brooks, Steven C ; Callaway, Clifton W ; Pepe, Paul E ; Rea, Thomas D ; Schmicker, Robert H ; Vaillancourt, Christian ; Chugh, Sumeet S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c704t-6aa644722aa27fb59f47389b2b9d69e99de8b112dc4c560ef8e708c026b8a71d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Age Distribution</topic><topic>Aged</topic><topic>Analysis</topic><topic>Canada - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Canadian Medical Association journal (CMAJ)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Reinier, Kyndaron</au><au>Thomas, Elizabeth</au><au>Andrusiek, Douglas L</au><au>Aufderheide, Tom P</au><au>Brooks, Steven C</au><au>Callaway, Clifton W</au><au>Pepe, Paul E</au><au>Rea, Thomas D</au><au>Schmicker, Robert H</au><au>Vaillancourt, Christian</au><au>Chugh, Sumeet S</au><aucorp>Resuscitation Outcomes Consortium Investigators</aucorp><aucorp>the Resuscitation Outcomes Consortium Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Socioeconomic status and incidence of sudden cardiac arrest</atitle><jtitle>Canadian Medical Association journal (CMAJ)</jtitle><addtitle>CMAJ</addtitle><date>2011-10-18</date><risdate>2011</risdate><volume>183</volume><issue>15</issue><spage>1705</spage><epage>1712</epage><pages>1705-1712</pages><issn>0820-3946</issn><eissn>1488-2329</eissn><coden>CMAJAX</coden><abstract>Low socioeconomic status is associated with poor cardiovascular health. We evaluated the association between socioeconomic status and the incidence of sudden cardiac arrest, a condition that accounts for a substantial proportion of cardiovascular-related deaths, in seven large North American urban populations.
Using a population-based registry, we collected data on out-of-hospital sudden cardiac arrests occurring at home or at a residential institution from Apr. 1, 2006, to Mar. 31, 2007. We limited the analysis to cardiac arrests in seven metropolitan areas in the United States (Dallas, Texas; Pittsburgh, Pennsylvania; Portland, Oregon; and Seattle-King County, Washington) and Canada (Ottawa and Toronto, Ontario; and Vancouver, British Columbia). Each incident was linked to a census tract; tracts were classified into quartiles of median household income.
A total of 9235 sudden cardiac arrests were included in the analysis. For all sites combined, the incidence of sudden cardiac arrestin the lowest socioeconomic quartile was nearly double that in the highest quartile (incidence rate ratio [IRR] 1.9, 95% confidence interval [CI] 1.8-2.0). This disparity was greater among people less than 65 years old (IRR 2.7, 95% CI 2.5-3.0) than among those 65 or older (IRR 1.3, 95% CI 1.2-1.4). After adjustment for study site and for population age structure of each census tract, the disparity across socioeconomic quartiles for all ages combined was greater in the United States (IRR 2.0, 95% CI 1.9-2.2) than in Canada (IRR 1.8, 95% CI 1.6-2.0) (p<0.001 for interaction).
The incidence of sudden cardiac arrest at home or at a residential institution was higher in poorer neighbourhoods of the US and Canadian sites studied, although the association was attenuated in Canada. The disparity across socioeconomic quartiles was greatest among people younger than 65. The association between socioeconomic status and incidence of sudden cardiac arrest merits consideration in the development of strategies to improve survival from sudden cardiac arrest, and possibly to identify opportunities for prevention.</abstract><cop>Canada</cop><pub>Joule Inc</pub><pmid>21911550</pmid><doi>10.1503/cmaj.101512</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Age Distribution Aged Analysis Canada - epidemiology Cardiac arrest Care and treatment Death, Sudden, Cardiac - epidemiology Disease prevention Female Health Status Disparities Heart attacks Humans Incidence Income Male Middle Aged Poisson Distribution Registries Regression Analysis Risk factors Social Class Social classes Socioeconomic factors Studies United States - epidemiology Urban Health |
| title | Socioeconomic status and incidence of sudden cardiac arrest |
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