Journal Article

Neighborhood Socioeconomic Environment and Incidence of Coronary Heart Disease: A Follow-up Study of 25,319 Women and Men in Sweden

Kristina Sundquist, Marilyn Winkleby, Helena Ahlén and Sven-Erik Johansson

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 159, issue 7, pages 655-662
Published in print April 2004 | ISSN: 0002-9262
Published online April 2004 | e-ISSN: 1476-6256 | DOI: https://dx.doi.org/10.1093/aje/kwh096
Neighborhood Socioeconomic Environment and Incidence of Coronary Heart Disease: A Follow-up Study of 25,319 Women and Men in Sweden

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In this study, the authors examined whether neighborhood socioeconomic environment predicted incident coronary heart disease after adjustment for individual-level characteristics. A random sample of the Swedish population (25,319 women and men aged 35–74 years) was interviewed between 1986 and 1993 and was followed through December 1997 for incident coronary heart disease (1,189 events). Neighborhood socioeconomic environment was defined by small-area market statistics (6,145 neighborhoods) and measured by two indicators: neighborhood education (proportion of people with less than 10 years of education in the neighborhood) and neighborhood income (proportion of people with incomes in the lowest national income quartile). Separate multilevel Cox proportional hazards models showed that low neighborhood education and low neighborhood income each predicted incident coronary heart disease after adjustment for age, sex, and individual-level education and income (hazard ratios were 1.25 and 1.23, respectively). The authors conclude that neighborhood socioeconomic environment predicts incident coronary heart disease, having a significant effect on coronary heart disease risk beyond the individual effect.

Keywords: coronary disease; follow-up studies; incidence; regression analysis; residence characteristics; social class; social environment; Abbreviations: CI, confidence interval; HR, hazard ratio; ICD, International Classification of Diseases; SAMS, small-area market statistics.

Journal Article.  5193 words. 

Subjects: Public Health and Epidemiology

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