Effects of social inequalities on coronary heart disease risk factors: a population-based, cross-sectional study in İzmir

Abstract

Aim of the study was to determine effects of social inequalities on coronary heart disease risk factors in individuals living in an urban district of Izmir; namely Balçova. In this cross-sectional study, no sampling was done and it was aimed to reach all residents living in that area aged 30 years and over (n=4409). Dependent variables were smoking, physical inactivity, unhealthy diet, obesity, hypertension, diabetes, dyslipidemia where social inequality was the independent variable. Educational status, income and social class were considered as the components of social inequality. Age, gender, family health histories were the confounding factors. Data were collected at home and in the neighborhood-house. For data analyses Chi-square test, and logistic regression analysis were used. Smoking is higher in men and women in lower socio economic class, where unhealthy diet is higher in self-employed men (OR=9.24, 95% CI=1.14-74.81, p=0.037) and in women who have a lower education (OR=1.53, 95% CI=1.02-2.30, p=0.040), lower income or unemployed (OR=3.43, 95% CI=1.28-9.14, p=0.014). Obesity is more frequent in lower educated women (OR=1.89, 95% CI=1.37-2.59, p<0.001) where decreased high-density lipoprotein cholesterol (HDL-C) is more frequent in men who have lower income (OR=2.21, 95% CI=1.20-4.07, p=0.011). Men who have a lower education (OR=0.61, 95% CI=0.38-0.98, p=0.039) or working as a skilled (OR=0.37, 95% CI=0.16-0.89, p=0.027) or an unskilled worker (OR=0.35, 95% CI=0.15-0.82, p=0.016) tend to have a decreased risk of obesity when working as a skilled worker (OR=0.53, 95% CI=0.29-0.95, p=0.033) decreases elevated low-density lipoprotein cholesterol. Coronary heart disease risk factors are high among participants who are aged 30 years and over. Men are under higher risk than women are. An increase in social inequalities causes decreased HDL-C in men, and increased smoking, unhealthy diet and obesity in women.