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Low socioeconomic status and psychological distress as synergistic predictors of mortality from stroke and coronary heart disease.
- Source :
-
Psychosomatic medicine [Psychosom Med] 2013 Apr; Vol. 75 (3), pp. 311-6. Date of Electronic Publication: 2013 Mar 26. - Publication Year :
- 2013
-
Abstract
- Background: The purpose of this study was to test whether lower socioeconomic status (SES) augments the effect of psychological distress on mortality from stroke or coronary heart disease (CHD).<br />Methods: We prospectively linked data from 66,500 participants 35 years or older in the Health Survey for England, selected using stratified random sampling from 1994 to 2004, and free of cardiovascular disease and cancer at baseline, with mortality records. The median follow-up time was 7.9 years. SES was indexed by occupational class, and psychological distress was assessed using the 12-item General Health Questionnaire (GHQ-12).<br />Results: After adjustment for demographic and clinical variables, both psychological distress and low SES were associated with increased mortality: the hazard ratios (HR) for one-category increase in low SES (three categories in total) were 1.15 for stroke-death (95% confidence interval [CI] = 1.00-1.31, p = .043) and 1.24 for CHD-death (95% CI = 1.09-1.41, p = .001); the HR for one-category increase in GHQ-12 (three categories in total) was 1.18 for stroke-death (95% CI = 1.07-1.30, p = .001) and 1.24 for CHD-death (95% CI = 1.13-1.36, p < .001). In stratified analyses, the strongest associations were found in the lowest SES categories: the HR for GHQ-12 toward stroke-death was 1.15 in high-SES participants (95% CI = 0.97-1.37, p = .107) and 1.31 in low-SES ones (95% CI = 1.13-1.51, p < .001); the HR for GHQ-12 toward CHD-death was 1.10 in high-SES participants (95% CI = 0.97-1.25, p = .129) and 1.33 in low-SES ones (95% CI = 1.19-1.48, p < .001).<br />Conclusions: People in low socioeconomic circumstances are more vulnerable to the adverse effect of psychological distress. This pattern should be taken into account when evaluating the association between psychosocial variables and health outcomes.
- Subjects :
- Adult
Aged
England epidemiology
Female
Follow-Up Studies
Health Surveys methods
Health Surveys statistics & numerical data
Humans
Male
Middle Aged
Prospective Studies
Risk Factors
Stress, Psychological psychology
Surveys and Questionnaires
Coronary Disease mortality
Coronary Disease psychology
Social Class
Stress, Psychological mortality
Stroke mortality
Stroke psychology
Subjects
Details
- Language :
- English
- ISSN :
- 1534-7796
- Volume :
- 75
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Psychosomatic medicine
- Publication Type :
- Academic Journal
- Accession number :
- 23533282
- Full Text :
- https://doi.org/10.1097/PSY.0b013e3182898e6d