Socioeconomic disparity in mortality and the burden of cardiovascular disease: analysis of the Prospective Urban Rural Epidemiology (PURE)-China cohort study

作者：Yingxuan Zhu, Yang Wang, Bangdiwala Shrikant, Lap Ah Tse, Yanyan Zhao, Zhiguang Liu, Chuangshi Wang, Quanyong Xiang, Sumathy Rangarajan, Sidong Li, Weida Liu, Mengya Li, Aiying Han, Jinhua Tang, Bo Hu, Salim Yusuf, Wei Li · 发表于：The Lancet Public Health · 年份：2023 · DOI：10.1016/s2468-2667(23)00244-x · 被引用次数：73 · 研究领域：Health disparities and outcomes、Cardiovascular Health and Risk Factors、Chronic Disease Management Strategies

BACKGROUND: Although socioeconomic inequality in cardiovascular health has long been a public health focus, the differences in cardiovascular-disease burden and mortality between people with different socioeconomic statuses has yet to be adequately addressed. We aimed to assess the effects of socioeconomic status, measured via three socioeconomic-status indicators (ie, education, occupation, and household wealth and a composite socioeconomic-status disparity index, on mortality and cardiovascular-disease burden (ie, incidence, mortality, and admission to hospital) in China. METHODS: For this analysis, we used data from the Prospective Urban Rural Epidemiology (PURE)-China cohort study, which enrolled adults aged 35-70 years from 115 urban and rural areas in 12 provinces in China between Jan 1, 2005, and Dec 31, 2009. Final follow-up was on Aug 30, 2021. Indicators of socioeconomic status were education, occupation, and household wealth; these individual indicators were also used to create an integrated socioeconomic-status index via latent class analysis. Standard questionnaires administered by trained researchers were used to obtain baseline data and were supplemeted by physical measurements. The primary outcomes were all-cause mortality, cardiovascular-disease mortality, non-cardiovascular-disease mortality, major cardiovascular disease, and cardiovascular-disease admission to hospital. Hazard ratios (HRs) and average marginal effects were used to assess the association bet...