Abstract
BackgroundVarious studies show major regional differences in the prevalence of cardio-vascular disease morbidity and mortality, both in Europe and within European countries. In Austria, these differences are documented by an East-West gradient with declining morbidity and mortality rates when moving from the East to the West of the country. It was the aim of this study to analyse if, and to what extent, socio-demographic and socio-economic determinants, social resources and health behaviour can contribute to the clarification of this East-West gradient by conducting secondary analyses of an existing Austrian health dataset.ResultsThe data were analysed using bivariate analyses, as well as univariate and multivariate logistic regression models. These analyses revealed significant East-West gradients for various risk factors, as well as socio-demographic and socio-economic health determinants. There was a gradual decrease of hypertension, diabetes mellitus, obesity, and psycho-social discomfort in both sexes, with the highest prevalences in those Austrian regions with the highest cardio-vascular mortality and a stepwise decrease to the regions with the lowest cardio-vascular mortality. Controlling for educational level significantly raised the odds for diabetes, hypertension and obesity. In the results of the multivariate analyses, factors that significantly and independently predicted diabetes mellitus were geographic location, psycho-social discomfort, lack of physical exercise, and age in both sexes. For women these factors additionally included a low educational level, lack of social support, and being born abroad.ConclusionsOur study shows a clear gradual decline of cardio-vascular mortality and some of its risk factors from East to West in Austria. Concerning these risk factors, the geographic region and psycho-social discomfort showed the greatest association with diabetes mellitus, hypertension, and obesity. Hence, they contribute to the explanation of the variance in spatial cardio-vascular disease mortality. Yet, a large proportion of this variance remains unexplained. It would be of great importance to public health and preventive measures to take a closer look at spatial differences in cardio-vascular disease morbidity and mortality to better tailor programmes to the regional environments and settings. Our results also call for a greater importance of preventative measures for psycho-social discomfort and increase of social support.
Highlights
In Europe, major differences in geographic regions regarding mortality from cardio-vascular diseases (CVD) have been observed with a high cardio-vascular mortality in the eastern and north-eastern European countries and a lower CVD mortality in western and south-western European countries [1,2,3]
It was the aim of this study to analyse if, and to what extent socio-demographic and socio-economic determinants, social resources and health behaviour can contribute to the clarification of an east-west gradient in CVD mortality in Austria by conducting secondary analyses of an existing health dataset
Further analysis brought to light that controlling for educational level significantly raised the odds for diabetes, hypertension and obesity, which leads to the conclusion that, if educational levels were equal in all Austrian regions, the east-west gradient in diabetes mellitus, hypertension, and obesity would be even more pronounced
Summary
In Europe, major differences in geographic regions regarding mortality from cardio-vascular diseases (CVD) have been observed with a high cardio-vascular mortality in the eastern and north-eastern European countries and a lower CVD mortality in western and south-western European countries [1,2,3]. For Austria, a similar east-west gradient has been reported for CVD mortality as for cardio-vascular risk factors like diabetes mellitus, obesity, or lack of physical exercise [9,10,11,12] It was the aim of this study to analyse if, and to what extent socio-demographic and socio-economic determinants, social resources and health behaviour can contribute to the clarification of an east-west gradient in CVD mortality in Austria by conducting secondary analyses of an existing health dataset. In Austria, these differences are documented by an East-West gradient with declining morbidity and mortality rates when moving from the East to the West of the country It was the aim of this study to analyse if, and to what extent, socio-demographic and socio-economic determinants, social resources and health behaviour can contribute to the clarification of this EastWest gradient by conducting secondary analyses of an existing Austrian health dataset
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