The burden of inequity: Income related disparities in cardiovascular risk factors in Europe
Pereira Silva, Ana Margarida ; Gimeno-Feliu, Luis Andrés ; Lopez-Rodriguez, Juan A.
Resumen: Objectives: To assess intercountry differences in social inequities related to cardiovascular risk factors across European countries in 2020.
Study design:Observational, cross-sectional study.
Methods: We analyzed data from the European Health Interview Survey (EHIS 3) (2018–2020) across 31 European countries. Focusing on adults over 40, with a sample of 248,420 participants. Socioeconomic position was assessed by net equivalised monthly income, analyzing six cardiovascular risk factors: dyslipidemia, diabetes, high blood pressure, obesity, smoking, and sedentary lifestyle. Descriptive analyses, prevalence estimation along with Poisson regression models and relative inequity indexes (RII) for quantification of health inequity among groups were calculated, considering survey weights.
Results: Significant geographical heterogeneity in prevalence and inequity indexes of all cardiovascular risk factors throughout Europe were found. Income presents a linear dose-response relationship with the prevalence of these factors (maximum for Diabetes, High blood pressure and Sedentary lifestyle), revealing some positive and inverse inequities (deviating from expected social gradient). Maximum gender disparity was found for Diabetes in women (RII = 2.265 [95 % CI]: 2.427–2.838) versus Men (RII = 1.785 [95 % CI]: 1.653–1.928) and inverse inequity (RII<1) for smoking habits in Bulgaria, Lithuania, Portugal and Romania.
Conclusions: This study highlighted significant income-related inequities in cardiovascular risk factors, with lower-income individuals exhibiting higher prevalence of dyslipidemia, diabetes, high blood pressure, obesity, smoking, and sedentary lifestyle. Country-specific variations were noted, with some countries experiencing a greater inequity, while others showed less pronounced inequity or even inverse inequalities. These findings highlight the need for equity-oriented healthcare services to reduce cardiovascular disease burden and address significant socioeconomic disparities.
Idioma: Inglés
DOI: 10.1016/j.puhe.2025.105978
Año: 2025
Publicado en: PUBLIC HEALTH 248 (2025), 105978 [21 pp.]
ISSN: 0033-3506
Tipo y forma: Artículo (Versión definitiva)
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Study design:Observational, cross-sectional study.
Methods: We analyzed data from the European Health Interview Survey (EHIS 3) (2018–2020) across 31 European countries. Focusing on adults over 40, with a sample of 248,420 participants. Socioeconomic position was assessed by net equivalised monthly income, analyzing six cardiovascular risk factors: dyslipidemia, diabetes, high blood pressure, obesity, smoking, and sedentary lifestyle. Descriptive analyses, prevalence estimation along with Poisson regression models and relative inequity indexes (RII) for quantification of health inequity among groups were calculated, considering survey weights.
Results: Significant geographical heterogeneity in prevalence and inequity indexes of all cardiovascular risk factors throughout Europe were found. Income presents a linear dose-response relationship with the prevalence of these factors (maximum for Diabetes, High blood pressure and Sedentary lifestyle), revealing some positive and inverse inequities (deviating from expected social gradient). Maximum gender disparity was found for Diabetes in women (RII = 2.265 [95 % CI]: 2.427–2.838) versus Men (RII = 1.785 [95 % CI]: 1.653–1.928) and inverse inequity (RII<1) for smoking habits in Bulgaria, Lithuania, Portugal and Romania.
Conclusions: This study highlighted significant income-related inequities in cardiovascular risk factors, with lower-income individuals exhibiting higher prevalence of dyslipidemia, diabetes, high blood pressure, obesity, smoking, and sedentary lifestyle. Country-specific variations were noted, with some countries experiencing a greater inequity, while others showed less pronounced inequity or even inverse inequalities. These findings highlight the need for equity-oriented healthcare services to reduce cardiovascular disease burden and address significant socioeconomic disparities.
Idioma: Inglés
DOI: 10.1016/j.puhe.2025.105978
Año: 2025
Publicado en: PUBLIC HEALTH 248 (2025), 105978 [21 pp.]
ISSN: 0033-3506
Tipo y forma: Artículo (Versión definitiva)
Debe reconocer adecuadamente la autoría, proporcionar un enlace a la licencia e indicar si se han realizado cambios. Puede hacerlo de cualquier manera razonable, pero no de una manera que sugiera que tiene el apoyo del licenciador o lo recibe por el uso que hace. No puede utilizar el material para una finalidad comercial. Si remezcla, transforma o crea a partir del material, no puede difundir el material modificado.Exportado de SIDERAL (2025-11-07-10:25:45)
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Registro creado el 2025-11-07, última modificación el 2025-11-07