Back to Annual Meeting

Back to Annual Meeting

APHA Scientific Session and Event Listing

Deborah Baker, PhD, Centre for Public Health Research, University of Salford, 7th Floor, Allerton Building, Frederick Road Campus, Salford, M6 6PU, United Kingdom, 0161 295 2814, D.J.Baker@salford.ac.uk, Elizabeth Middleton, National Primary Care Research and Development Centre, University of Manchester, Williamson Building, Oxford Road, Manchester, M13 9PL, United Kingdom, and Philip Lewis, MD, Department of Cardiology, Stockport Primary Care Trust, Stepping Hill Hospital, Stockport, United Kingdom.

Background: The extent to which population based screening for cardiovascular disease risk factors constitutes an ‘upstream' means of reducing health disparities in CHD morbidity and mortality has not been established. Methods 82,015 residents of Stockport Health Authority, UK age 35-60 took up an invitation to be screened for cardiovascular disease risk factors from 1989 -1999. Poisson regression analyses with CHD mortality and hospital admission rates (1997-2003) as the dependent variables were used to compare the relative probability of dying or of being admitted to hospital between the screened and the unscreened population, controlling for age and deprivation. T tests identified significant differences in CHD mortality and hospital admissions between screened and unscreened populations in affluent and deprived areas and by gender. Results CHD mortality and hospital admissions were significantly more likely for unscreened men compared with screened men (IRR=3.60; p<0.001, IRR=1.75, p<0.001 respectively). Findings were similar for women (IRR=4.64, p<0.001, IRR=1.94, p<0.001 respectively). This was independent of age and deprivation. For both men and women mean rates of CHD mortality and hospital admissions were significantly lower for those who were screened and living in deprived areas compared to those who were unscreened and living in affluent areas. Mean rates of mortality were significantly lower for screened men, compared with unscreened women. Discussion Screening for cardiovascular disease risk factors improves the cardiovascular health of the population by targeting and treating ‘high risk' groups. If access to screening is equitable, then screening also has the potential to reduce health disparities.

Learning Objectives:

• Participants will develop a perspective about the utility of population screening as a means of reducing health disparities in CHD morbidity and mortality. This will enable them to assess the value of this intervention as a means of improving the cardiovascular health of disadvantaged populations

Keywords: Screening, Health Disparities

Presenting author's disclosure statement:

Not Answered