Abstract P170: Neighborhood Socioeconomic Inequalities in Incidence of Acute Myocardial Infarction: a Relative and Absolute Perspective with Reference to Age and Gender.

Abstract

Background: Socioeconomic circumstances (SEC) have a profound effect on the risk of having a first coronary heart disease (CHD) event. Yet, information on socioeconomic inequalities across age- and gender-groups is lacking. The objective of this study was to examine socioeconomic inequalities in the incidence of acute myocardial infarction (AMI) in the Netherlands from a relative and absolute perspective, with a particular focus on age and gender. Methods: We identified all patients with a first AMI event from 1997 to 2007 through linked hospital discharge and death records covering the Dutch population (176,715,060 person-years). Relative risks (RR) of AMI incidence were estimated by mean equivalent household income at neighborhood level for strata of age and gender using Poisson regression models. The absolute magnitude of socioeconomic inequalities was estimated by multiplication of population attributable risks (PAR) with the total number of AMI events within the stratified age-gender groups. Results: Between 1997 and 2007, 317,564 people had a first AMI. RR for AMI was 1.34 (95% CI: 1.32 - 1.36) in men and 1.44 (95% CI: 1.42 - 1.47) in women, when comparing the most deprived socioeconomic quintile with the least deprived quintile. The socioeconomic gradient decreased with age. Relative socioeconomic inequalities were most apparent in men under 35 years and in women under 65 years. A total of 50,362 events were attributable to socioeconomic inequalities, with a PAR of 14% in men and 18% in women. The largest burden of absolute AMI events attributable to socioeconomic inequalities was found in men aged 45-74 years, and to a lesser extent in women aged 65-84 years. Conclusion: Neighborhood socioeconomic inequalities are seen for AMI incidence in all age-gender groups in the Netherlands.