Abstract P468: Geographic and Socioeconomic Inequalities in Poor Cardiovascular Health in Canada

Abstract

Background: Poor cardiovascular health (CVH), characterized by clinical risk and unhealthy lifestyle habits, is a leading cause of death and disease worldwide. Despite advances in healthcare and policy, there remains an inequitable burden of poor CVH among Canadian sub-populations based on socioeconomic status and geographic region. Using recently published data and a national toolkit, this study aimed to quantify inequalities in poor CVH across the Canadian population. Methods: We conducted a cross-sectional study on Canadian adults, ≥20 years, from the nationally representative Canadian Community Health Survey 2017. Using the American Heart Association’s CVH Index, CVH was defined for each individual as a summed score of 7 components, where 1 point was awarded for achieving ideal health in each component. A total score of 0-2 points indicated poor overall CVH. The Canadian Institute for Health Information (CIHI) Measuring Health Inequalities Toolkit, a standardized methodological approach to analyzing health inequalities in population-based data using pre-defined stratifications and second-level interactions, was used to quantify inequalities in poor CVH based on Toolkit-defined stratifications in sex, income, urban/rural status, and region of residence. The regional distribution of CVH was mapped using ArcGIS software. Results: Approximately 7% of Canadians had poor CVH, representing 2 million Canadians. Poor dietary habits were noted in 99.0% of the population, with poor body mass index and poor physical activity noted in 58.1% and 42.3%, respectively. The eastern provinces of Newfoundland and Labrador and New Brunswick had the greatest proportion of health regions with poor CVH. An examination of the largest CVH inequalities across provinces revealed that females in the lowest income tercile residing in Prince Edward Island were 8-times more likely to experience poor CVH than females in the highest income tercile (RR 8.43, 95%CI 7.09-10.04). Additionally, females in New Brunswick residing in rural regions were almost 3-times more likely to experience poor CVH than females residing in urban regions (RR 3.07, 95%CI 1.07-4.87). In most provinces, income and urban/rural inequalities among males were observed but were of smaller magnitude than the inequalities among females. Conclusion: The greatest inequalities in poor CVH were experienced by females in the lowest income groups. Urban/rural inequalities in CVH were complex and varied by geographic region. The CIHI toolkit is a robust and systematic approach to understanding health inequalities that will enable comparison between studies and health/disease states, and thus facilitate comparative policy evaluation and population health priority setting.