A registry-based follow-up study, comparing the incidence of cardiovascular disease in native Danes and immigrants born in Turkey, Pakistan and the former Yugoslavia: do social inequalities play a role?

Nana F Hempler,Finn Diderichsen,Finn B Larsen,Signe S Nielsen,Anne H Andreasen,Torben Jørgensen

doi:10.1186/1471-2458-11-662

Nana F Hempler, Finn Diderichsen + Show 4 more

Open Access

https://doi.org/10.1186/1471-2458-11-662

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Abstract

BackgroundThis study compared the incidence of cardiovascular disease (CVD) and acute myocardial infarction (AMI) between native Danes and immigrants born in Turkey, Pakistan and the former Yugoslavia. Furthermore, we examined whether different indicators of socioeconomic status (SES), such as employment, income and housing conditions influenced potential differences.MethodsIn this registry-based follow-up study individuals were identified in a large database that included individuals from two major regions in Denmark, corresponding to about 60% of the Danish population. Incident cases of CVD and AMI included fatal and non-fatal events and were taken from registries. Using Cox regression models, we estimated incidence rates at 5-year follow-up.ResultsImmigrant men and women from Turkey and Pakistan had an increased incidence of CVD, compared with native Danish men. In the case of AMI, a similar pattern was observed; however, differences were more pronounced. Pakistanis and Turks with a shorter duration of residence had a lower incidence, compared with those of a longer residence. Generally, no notable differences were observed between former Yugoslavians and native Danes. In men, differences in CVD and AMI were reduced after adjustment for SES, in particular, among Turks regarding CVD. In women, effects were particularly reduced among Yugoslavians in the case of CVD and in Turks in the case of CVD and AMI after adjustment for SES.ConclusionsIn conclusion, country of birth-related differences in the incidence of CVD and AMI were observed. At least some of the differences that we uncovered were results of a socioeconomic effect. Duration of residence also played a certain role. Future studies should collect and test different indicators of SES in studies of CVD among immigrants.

Highlights

This study compared the incidence of cardiovascular disease (CVD) and acute myocardial infarction (AMI) between native Danes and immigrants born in Turkey, Pakistan and the former Yugoslavia
The stratified analyses showed a relatively consistent pattern among women regarding the influence of socioeconomic status (SES), with the exception of employment, in which retired Pakistani and Turkish women had a lower incidence, compared with those employed, while the opposite was the case among native Danes and Former Yugoslavian women (Table 2)
We observed that immigrant groups that were retired had a lower incidence of CVD, compared to those employed, whereas retired native Danes had an increased incidence

Summary

Introduction

This study compared the incidence of cardiovascular disease (CVD) and acute myocardial infarction (AMI) between native Danes and immigrants born in Turkey, Pakistan and the former Yugoslavia. According to a European collaborative project, reliable and comparable data on cardiovascular disease (CVD) in migrant and ethnic minority groups are scattered, incomplete and missing in most European countries [1]. In Denmark, it is challenging to conduct epidemiological studies concerning immigrants’ health, because Denmark is a small country and has one of the smallest immigrant populations in Western Europe. In 2010, immigrants and their descendants constituted about 10% of the total population, and two thirds originated from a non-Western country [16]. The abovementioned immigrant groups represent the groups with the longest duration of residence and the highest average age in Denmark from non-Western countries [17]

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