Socioeconomic position and incidence of cardiovascular diseases (CVD) among Inuit in Nunavik, Canada

Background: Compared to traditional behavioral and clinical risk factors associated with cardiovascular diseases (CVD), the role of social determinants on the incidence of CVD among the circumpolar Inuit has received less attention.  

Objective: Analyze, using prospective data, the association between socioeconomic position (SEP) and risk of CVD among Inuit in Nunavik (Canada).

Methods: We analyzed data from Inuit adults (aged 18-74 years) who participated to  “Qanuippitaa? How are we?” Nunavik Inuit Health Survey. After excluding prevalent cases of CVD at baseline (2004), data from 745 adults were available for analysis. At baseline, participants provided information via questionnaires about their health, lifestyles, and socioeconomic characteristics, and attended a clinical session during which blood samples were collected. In 2011, medical files were reviewed to assess new cases of CVD (ICD 390-451). SEP was determined using information on income, education and employment. Multiple logistic regression analysis was used to estimate multivariate-adjusted odds ratio (ORs) between SEP and incidence of CVD events.

Results: During the 7-year follow-up, there were 63 (8.5%) incident cases of CVD. After adjustment for clinical and behavioral risk factors, the ORs for incidence of CVD were 2.31 (95% confidence interval: 1.23, 4.37) among people with lower SEP at baseline.

Conclusion: In addition to interventions targeting proximal (behavioral and clinical) risk factors of CVD, our findings suggest that upstream efforts to improve the socioeconomic and living conditions in the Canadian Arctic are likely to contribute to reducing the burden of CVD among the Inuit.