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Cardiovascular disease occurrence in two close but different social environments
Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department for Studies of Social Change and Culture. Linköping University, Faculty of Arts and Sciences.
Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department for Studies of Social Change and Culture, Centre for Local History. Linköping University, Faculty of Arts and Sciences.
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2011 (English)In: INTERNATIONAL JOURNAL OF HEALTH GEOGRAPHICS, ISSN 1476-072X, Vol. 10, no 5Article in journal (Refereed) Published
Abstract [en]

Background: Cardiovascular diseases estimate to be the leading cause of death and loss of disability-adjusted life years globally. Conventional risk factors for cardiovascular diseases only partly account for the social gradient. The purpose of this study was to compare the occurrence of the most frequent cardiovascular diseases and cardiovascular mortality in two close cities, the Twin cities. Methods: We focused on the total population in two neighbour and equally sized cities with a population of around 135 000 inhabitants each. These twin cities represent two different social environments in the same Swedish county. According to their social history they could be labelled a "blue-collar" and a "white-collar" city. Morbidity data for the two cities was derived from an administrative health care register based on medical records assigned by the physicians at both hospitals and primary care. The morbidity data presented are cumulative incidence rates and the data on mortality for ischemic heart diseases is based on official Swedish statistics. Results: The cumulative incidence of different cardiovascular diagnoses for younger and also elderly men and women revealed significantly differences for studied cardiovascular diagnoses. The occurrence rates were in all aspects highest in the population of the "blue-collar" twin city for both sexes. Conclusions: This study revealed that there are significant differences in risk for cardiovascular morbidity and mortality between the populations in the studied different social environments. These differences seem to be profound and stable over time and thereby give implication for public health policy to initiate a community intervention program in the "blue-collar" twin city.

Place, publisher, year, edition, pages
BioMed Central , 2011. Vol. 10, no 5
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-66880DOI: 10.1186/1476-072X-10-5ISI: 000286525800001OAI: oai:DiVA.org:liu-66880DiVA: diva2:405296
Note
Original Publication: Carina Wennerholm, Björn Grip, AnnaKarin Johansson, Hans Nilsson, Marja-Liisa Honkasalo and Tomas Faresjö, Cardiovascular disease occurrence in two close but different social environments, 2011, INTERNATIONAL JOURNAL OF HEALTH GEOGRAPHICS, (10), 5. http://dx.doi.org/10.1186/1476-072X-10-5 Licensee: BioMed Central http://www.biomedcentral.com/Available from: 2011-03-22 Created: 2011-03-21 Last updated: 2017-09-18
In thesis
1. Risks for cardiovascular disease in middle-aged women in different social environments
Open this publication in new window or tab >>Risks for cardiovascular disease in middle-aged women in different social environments
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: The importance of the social environment and human life conditions for public health was early recognized in community medicine. Despite major reductions in recent decades, cardiovascular diseases (CVD) is one of the leading causes of mortality and morbidity for both genders in all European countries. 

Aim: The overall aim of this thesis was to increase our knowledge of factors in the social environment and of individual psychosocial factors that could explain why some women in working ages are affected by cardiovascular diseases.

Methods: The Swedish sample comes from the urban population in two major cities in a region in the south-east of Sweden, the Twin cities. According to their social history they could be labelled a “blue-collar” and a “white-collar” city. Cardiovascular morbidity data in all papers for the Twin cities was derived from a computerized population-based administrative Health Care Register (HCR). In Paper IV, we made a comparative study between Sweden and Scotland, the Scottish data comes from the Scottish Health Survey.

Results: In Paper I, the cumulative incidence of different cardiovascular diagnoses for younger and also elderly men and women were significantly higher in the population of the blue collar city in all ages and for both sexes. The qualitative interviews of women after an MI, in Paper II, the findings revealed a broad picture of social factors, life circumstances, personalities and, not least, psychosocial factors that are important to middle-aged women who have suffered an MI. Paper III demonstrated that women with a high level of the personality trait “being a Good Girl” reported significantly more psychosocial risk factors for CVD and more commonly report chest pain without seeking medical care, no increased incidence for various CVD-diagnoses were found. The comparative study (Paper IV) clearly showed that Scottish middle-aged women are – relative to Swedish women - particularly affected by a worse profile of CVD risks, even after adjustment for education.  

Conclusions: The social environment is of importance for cardiovascular risks and cardiovascular morbidity and mortality. This has been shown in Swedish Twin cities context and also in comparative studies between Swedish and Scottish women. The thesis gives strong implications for an upstream public health approach initiating long-term community intervention program in the blue collar city and among Scottish middle-aged women.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2017. 91 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1577
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-140934 (URN)10.3384/diss.diva-140934 (DOI)9789176854976 (ISBN)
Public defence
2017-09-29, Belladonna, ing 76/78, Campus Valla, Linköping, 13:00 (English)
Opponent
Supervisors
Funder
The Swedish Heart and Lung Association, E136-15/E106/13
Available from: 2017-09-18 Created: 2017-09-18 Last updated: 2017-09-18Bibliographically approved

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Wennerholm, CarinaGrip, BjörnJohansson, AnnaKarinNilsson, HansHonkasalo, Marja-LiisaFaresjö, Tomas
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