Inequalities by education and marital status in the co-occurrence of cardiovascular risk factors in Finland persisted between 1997\u20132017

Laura Paalanen,Jukka Kontto,Hanna Tolonen,Tommi Härkänen

doi:10.1038/s41598-020-65959-1

Laura Paalanen, Jukka Kontto + Show 2 more

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https://doi.org/10.1038/s41598-020-65959-1

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Journal: Scientific Reports	Publication Date: Jun 4, 2020
Citations: 5	License type: open-access

Affiliation: Finnish Institute for Health and Welfare

Abstract

Understanding on sociodemographic variation of the co-occurrence of cardiovascular disease risk factors is crucial for planning future prevention strategies. We aimed at examining (1) the co-occurrence of smoking, obesity, hypertension and elevated serum cholesterol by education and marital status, and (2) its trends in different sociodemographic groups in Finland. We used data from cross-sectional health examination surveys among the general population (25–64 years): for 1997–2012 the National FINRISK Study and for 2017 the FinHealth 2017 Survey (n = 25036). A risk factor accumulation score with categories (1) zero, (2) one, (3) two, and (4) three or four elevated risk factors was the outcome in multinomial logistic regression. The risk factor score was more favourable among women, among high education groups, and slightly among participants living with a spouse. Among men, the lowest risk factor score class became more prevalent especially in the intermediate education group, which approached the highest education group over time. Our results indicate an overall transition towards a more favourable risk factor distribution. However, risk factor accumulation among the least educated remained emphasizing the need to develop and implement more targeted prevention interventions and public health policies to decrease the risk factor burden particularly in this group.

Highlights

The co-occurrence of major chronic disease risk factors and its association with a broad range of health outcomes such as mortality, life expectancy, onset of cardiovascular disease (CVD) and health-related quality of life has been reported in literature[4,5,6,7,8]
Vast literature on the co-occurrence of risk factors exists, the temporal changes in the co-occurrence or, in the sociodemographic variation or the tendency of the risk factors to accumulate in lower socioeconomic groups have not been extensively studied
In Finland, the trends in the variation in unhealthy behaviour among Finnish men from 1982 to 1990 have been examined, and unhealthy behavior was especially common among divorced men with a low educational level[13]

Summary

Introduction

The co-occurrence of major chronic disease risk factors and its association with a broad range of health outcomes such as mortality, life expectancy, onset of cardiovascular disease (CVD) and health-related quality of life has been reported in literature[4,5,6,7,8]. The understanding on sociodemographic variation of the co-occurrence of risk factors, either biological risk factors or unhealthy lifestyles, is crucial for planning public health policy and future prevention strategies. Vast literature on the co-occurrence of risk factors exists, the temporal changes in the co-occurrence or, in the sociodemographic variation or the tendency of the risk factors to accumulate in lower socioeconomic groups have not been extensively studied. We aimed at examining the co-occurrence of major CVD risk factors, namely smoking, obesity, hypertension, and elevated serum total cholesterol, by education and marital status using data from large population-based surveys among adults covering years 1997–2017 from Finland. We aimed to examine temporal changes in the sociodemographic differences in the co-occurrence of these risk factors

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