Effects of social inequalities on coronary heart disease risk factors

The objective of this cross sectional study was to determine the effect of social inequalities on risk factors of coronary heart disease (CHD) and ten years risk of developing CHD in residents of Cetin Emec Neighbourhood, Balcova District in Izmir who are 30 years of age and above (n=4409).Dependent variables were smoking, being physically inactive, unhealthy diet, obesity, hypertension (HT), diabetes, dyslipidaemia and ten years risk of CHD where the independent variable was social inequality (education status, income and social class). Probable confounding factors were age and sex. Data was collected at home and neighborhood-house and analyzed via student t test, chi-square and logistic regression. In logistic regression, for educational status `high school and above?, for income `1000 TL and higher? and for social class `being an employer? groups were considered as the reference categories.In men, educational status, income and social class didn?t affect physical inactivity, HT and diabetes risk significantly. Among men smoking was more frequent in self employed (OR=2.90, 95%CI 1.43-5.86), white collar-highly qualified worker (OR=1.95, 95%CI 1.06-3.59), blue collar-unqualified worker (OR=3.96, 95%CI 2.18-7.22), unemployed (OR=4.32, 95%CI 1.97-9.47); unhealthy diet was more frequent in self employed (OR=9.24, 95%CI 1.14-74.81) groups. Low HDL-C levels were 2.21 (95%CI 1.20-4.07) fold more frequent among low income group. Lower educated men had 1.89 (95%CI 1.26-2.82) fold higher ten years risk for developing CHD. Lower education status, being white collar-highly qualified worker or being blue collar-unqualified worker was protective against obesity, where being white collar-highly qualified worker was protective against LDL-C risk.In women; educational status, income and social class was not associated with physical inactivity, HT, diabetes, LDL-C and HDL-C risk. Among women, smoking was more frequent in blue collar-unqualified worker (OR=1.72, 95%CI 1.09-2.74) and unemployed (OR=2.16, 95%CI1.27-3.70); unhealthy diet was more frequent in lower educated (OR=1.53, 95%CI 1.02-2.30), whose income was between 500-999 TL (OR=2.17, 95%CI 1.25-3.76), whose income was between 0-499 TL (OR=3.88, 95%CI 2.20-6.85) and unemployed (OR=3.43, 95%CI 1.28-9.14) group. Lower educated women had 1.89 (95%CI 1.37-2.59) fold increase risk for being obese. Lower education and unemployment increased ten years risk of CHD for 5.32 (95%CI 3.34-8.48) fold and 2.11 (95%CI 1.04-4.24) fold respectively.In men, inequalities affect smoking, unhealthy diet, HDL-C level and ten years risk of CHD where in women they affect smoking, unhealthy diet, obesity and ten years risk of CHD unfavorably.