Abstract MP18: Associations of Individual and Area-Based Socioeconomic Status With Cardiovascular Outcomes and Mortality: A Prospective Cohort Study

Abstract

Introduction: Evidence is limited regarding the interactions between individual socioeconomic status (SES) and neighborhood deprivation on long-term health outcomes. We aimed to evaluate the joint impacts of individual- and area-based SES on risks of disease-specific incidence and mortality. Hypothesis: We hypothesized that neighborhood deprivation would be related to disproportionate harm on health outcomes in those of lower individual SES. Methods: Data were sourced from UK Biobank. We assessed individual SES by self-reported education attainment (college or university degree/others) and measured area-based SES by the Townsend deprivation index (in quintiles: Q1 was the least deprived and Q5 was the most deprived). Poisson regression was used to examine the associations of individual- and area-based SES with incident CVD and heart failure (HF), and mortality from all, CVD, and cancer causes. Results: During a mean follow-up of 11.9-12.3 years, we documented 24,936 incident CVD cases, 10,887 HF cases, and 36,584 deaths. Individual- and area-based SES were each significantly associated with higher risks of incident cardiovascular events and mortality. Compared with those with college/university degrees, the multivariable-adjusted relative risks (95% CIs) for less-educated participants were 1.18 (1.14, 1.21) for CVD, 1.24 (1.19, 1.30) for HF, 1.14 (1.12, 1.17) for all-cause mortality, 1.11 (1.05, 1.17) for CVD mortality, and 1.09 (1.06, 1.13) for cancer mortality. Being in the Q5 group (vs. Q1) was associated with 19-48% higher risks of health outcomes. A significant interaction between education attainment and neighborhood deprivation was found for incident CVD and HF, all-cause and cancer mortality, but not for CVD mortality (Fig1). The associations between higher deprivation and increased risks of CVD events and mortality were more prominent in less-educated subgroups. Conclusions: The detrimental impacts of neighborhood deprivation on health outcomes might be exacerbated by low education attainment.