Heart
Volume 100, Issue 3, 2014, Pages 239-246

Socioeconomic inequalities in acute myocardial infarction incidence in migrant groups: Has the epidemic arrived? Analysis of nation-wide data (Article)

Agyemang C.* , Van Oeffelen A.A.M. , Bots M.L. , Stronks K. , Vaartjes I.
  • a Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
  • b Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
  • c Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
  • d Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
  • e Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands

Abstract

Objectives We assessed socioeconomic inequalities in relation to acute myocardial infarction (AMI) incidence among major ethnic groups in The Netherlands. Methods A nationwide register-based cohort study was conducted (n=2 591 170) between 1 January 1998 and 31 December 2007 among ethnic Dutch and migrant groups from Suriname, Netherlands Antilles, Indonesia, Morocco and Turkey. Standardised household disposable income was used as a proxy for socioeconomic position. Cox proportional hazard models were used to estimate the socioeconomic inequalities in AMI incidence. Results Among ethnic Dutch, the AMI incidence was higher in the low-income group than in the high-income group: adjusted HRs were 2.05 (95% CI 2.00 to 2.10) for men and 2.33 (95% CI 2.23 to 2.43) for women. Importantly, similar socioeconomic inequalities in AMI incidence were also observed in all minority groups, with the low socioeconomic group having a higher AMI incidence than the high socioeconomic group: adjusted HR ranging from 2.07 (95% CI 1.26 to 3.40) in Moroccans to 2.73 (95% CI 1.55 to 4.80) in Antilleans in men; and from 2.17 (95% CI 1.74 to 2.71) in Indonesians to 3.88 (95% CI 2.36 to 6.38) in Turks in women. Conclusions Our findings demonstrate socioeconomic inequalities in AMI incidence in migrant groups and suggest a convergence towards the Dutch general population. If the AMI incidence rates of the low socioeconomic group could be reduced to the level of the high socioeconomic group, this would represent a major public health improvement for all ethnic groups.

Author Keywords

[No Keywords available]

Index Keywords

Netherlands immigrant Antillean Myocardial Infarction Proportional Hazards Models Turk Indonesian MYOCARDIAL ISCHAEMIA AND INFARCTION (IHD) Health Status Disparities Dutch human comorbidity middle aged Cohort Studies Ethnic Groups ethnic group controlled study priority journal Epidemics income social status Humans ethnic difference Minority Groups male female Socioeconomic Factors population research Incidence Article major clinical study adult cohort analysis acute heart infarction Transients and Migrants Moroccan

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84891834919&doi=10.1136%2fheartjnl-2013-304721&partnerID=40&md5=e43d68915a97c430a76485843ed5c60e

DOI: 10.1136/heartjnl-2013-304721
ISSN: 13556037
Cited by: 6
Original Language: English