Cardiovascular and cerebrovascular mortality and social disadvantage in France in 2011

Introduction: Socioeconomic disparities within a population lead to differences in mortality rates. This article describes the link between mortality and social disadvantage for myocardial infarction (MI), stroke, heart failure (HF), and pulmonary embolism (PE) in mainland France in 2011. Methods: Data were drawn from the national database of medical causes of death. For each of the selected causes, mortality rates were calculated by population quintile according to the Fdep09 ecological index of social disadvantage. The association between mortality and social disadvantage was measured by the ratio of the standardized rate in the most disadvantaged quintile (Q5) to that in the least disadvantaged quintile (Q1). Interaction with age and sex was tested using Poisson regression. Results: Mortality was significantly higher in the most disadvantaged population quintile compared to the least disadvantaged for heart disease (Q5/Q1 ratio = 1.51, 95% CI: [1.43–1.59]), stroke (1.36 [1.30–1.41]), heart failure (1.45 [1.42–1.49]), and pulmonary embolism (1.39 [1.31–1.48]). Regardless of the cause, mortality disparities were significantly greater among individuals under 65 years of age than among those aged 65 and older, in both men and women. For stroke, the disparities were greater among men than among women. Conclusion: For the four leading causes of cardio-neuro-vascular death, mortality increased with social disadvantage. The implementation of measures to reduce these inequalities—a priority of the national health strategy—must be accompanied by monitoring the evolution of these indicators over time and across regions.

Author(s): Lecoffre C, Decool E, Olie V

Publishing year: 2016

Pages: 352-8

Weekly Epidemiological Bulletin, 2016, n° 20-21, p. 352-8

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