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Socioeconomic disparities in incident acute myocardial infarction in rural areas of Denmark: A spatial analysis approach
Objective To identify and examine areas with low versus high risk of incident AMI and investigate whether neighborhood service facilities mediate the association between neighborhood SEP and clusters with high risk of incident AMI (CHRIA) in rural areas.
Methods Data on AMI, SEP, businesses locations, and geographical coordinates were obtained from nationwide registers. Spatial scan statistics were applied to identify clusters with high and low risk of incident AMI. Logistic regression models were performed to evaluate the association between neighborhood SEP and odds of living in CHRIA.
Results The study population consisted of 93,549 people living in either clusters of high (47.8%) or low risk of incident AMI in rural areas. Decreasing median household income and proportion of immigrants/descendants in the neighborhood were associated with increased odds of living in CHRIA (Odds Ratio (OR)=0.92, 95% confidence interval=[0.92;0.92] and OR=0.69[0.67;0.70], respectively). An increasing proportion of elderly (OR=1.25[1.24;1.25]) and unemployed (OR=2.91[2.84;2.97]) in the neighborhood was positively associated with living in CHRIA. Number of supermarkets (OR=0.94[0.93-0.95]), sports facilities (OR=0.61[0.60;0.61]), and the proportion of general practitioners (OR=0.78[0.77;0.79]) in the area was negatively associated with living in CHRIA; however, these service facilities did not seem to mediate the association between neighborhood SEP and living inside CHRIA.
Conclusions Spatial analysis may be an important tool that enables health professionals to develop more evidence-based prevention strategies targeting health inequalities.
Learning Areas:
EpidemiologyLearning Objectives:
Describe differences in neighborhood socioeconomic position in rural areas with high versus low risk of incident AMI.
Evaluate service facilities in the neighborhood as a mediator of the association between neighborhood socioeconomic position and areas with high risk of incident AMI.
Qualified on the content I am responsible for because: I have a master degree in Public Health Science and I am working in the field of spatial epidemiology at the National Institute of Public Health, University of Southern Denmark. My main research interest has been the social and geographical inequalities of cardiovascular diseases and how information from nationwide registers and spatial analysis can contribute to an increased understanding of the social and geographical patterns in cardiovascular diseases.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.