Archives of Hellenic Medicine

Last update:

21-Apr-2019

Arch Hellen Med, 37(3), May-June 2019, 383-392

ORIGINAL PAPER

Socioeconomic inequalities and cardiovascular disease risk during the economic crisis in Greece:
10-year follow-up of the ATTICA study (2002–2012)

S. Koliofoutis,¹ N. Kollia,¹ E. Georgousopoulou,¹ C. Chrysohoou,² C. Papageorgiou,³ C. Pitsavos,² D. Panagiotakos¹
¹Department of Nutrition-Dietetics, School of Health Science and Education, Harokopio University, Athens,
²First Department of Cardiology, "Hippokration" General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens,
³First Department of Psychiatry, "Eginition" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

OBJECTIVE To explore the effect of low socio-economic status (SES) on the 10-year incidence of cardiovascular disease (CVD), in the years of the Greek financial crisis.

METHOD This population-based study was carried out in the province of Attica, where Athens is the major metropolis. During 2001–2002, information was collected from 1,528 men aged 18–87 years and 1,514 women aged 18–89 years. The educational level and annual income were used to define their SES. After a 10-year period (2002–2012) the incidence of CVD was recorded in the study population.

RESULTS At ages above 40 years, low compared to high SES class was independently associated with an increased 10-year CVD incidence, with adjusted odds ratio and 95% confidence interval: 2.9 (1.6, 5.1), but no association was observed among the younger participants. SES was negatively associated with psychological disorders (all p-values <0.001), diabetes mellitus (DM) (p=0.002), obesity (p=0.087) and less physical activity (p=0.091).

CONCLUSIONS This study provided evidence of a consistent inverse relationship between SES and the incidence of CVD and documents, higher rates of CVD risk factors among less privileged individuals. These striking differences according to SES underscore the critical need to improve the screening, early detection, and treatment of CVD-related conditions among lower SES populations, with an emphasis on the middle-aged groups. A wider multidisciplinary approach should be taken to tackling the socioeconomic health inequalities.

Key words: Cardiovascular disease, Incidence, Risk, Socioeconomic inequalities.