Education inequalities in cardiovascular and coronary heart disease in Italy and the role of behavioral and biological risk factors

• DOI: 10.1016/j.numecd.2021.10.022
• Publication Date: 2021-11-25T01:26:46Z
• Authors: Alessio Petrelli; Gabriella Sebastiani; Anteo Di Napoli; Alessandra Macciotta; Paola Di Filippo; Elena Strippoli; Concetta Mirisola; Angelo d’Errico
• Keywords: Male; 03 medical and health sciences; 0302 clinical medicine; Social Class; Cardiovascular Diseases; Risk Factors; 4. Education; Educational Status; Humans; Coronary Disease; Female; 0305 other medical science; 3. Good health

Behavioral and biological risk factors (BBRF) explain part of the variability in socioeconomic differences health. The present study aimed at evaluating education incidence cardiovascular disease (CVD) coronary heart (CHD) Italy role BBRF.All subjects aged 30-74 years (n = 132,686) who participated to National Health Interview Surveys 2000 2005 were included followed-up for ten years. Exposure smoking, physical activity, overweight/obesity, diabetes hypertension baseline was considered. Education level used as an indicator status. outcomes incident cases CVD CHD. Hazard ratios by estimated, adjusting sociodemographic covariates stratifying sex geographic area. contribution BBRF inequalities estimated counterfactual mediation analysis, addition assessment attenuation comparing models including or not. 22,214 participants had a event 6173 CHD event. After controlling factors, least educated men showed 21% higher 17% compared most (41% 61% among women). mediating effect (natural indirect effect) between extreme levels 52% 84% (16% women CVD).More effective strategies aiming reducing disparities are needed, through programs targeting less people combination with community-wide initiatives.