Geographical clustering of incident acute myocardial infarction in Denmark: A spatial analysis approach. (November 2016)

• Record Type: Journal Article
• Authors: Kjærulff, Thora Majlund; Ersbøll, Annette Kjær; Gislason, Gunnar; Schipperijn, Jasper
• Is Part Of: Spatial and spatio-temporal epidemiology. Volume 19(2016)
• Page Start: 46
• Page End: 59
• Publication Date: 2016-11
• Subjects: Acute myocardial infarction -- Spatial statistics -- Clustering -- Registers -- Socioeconomic position; AMDHI Annual median disposable household income -- AMI Acute myocardial infarction -- BHR Building and Housing Register -- CPR-number Unique personal identification number -- CRS Danish Civil Registration System -- GIS Geographical Information Systems -- ID Immigrant and descendants -- ISR Income Statistics Register -- NPR Danish National Patient Register -- RCD Danish Register of Causes of Death -- SEP Socioeconomic position; Epidemiology -- Statistical methods -- Periodicals; Epidemiology -- Periodicals; 614.4072
• DOI: 10.1016/j.sste.2016.05.001
• Languages: English
• ISSNs: 1877-5845

Abstract

Highlights: Individual-level register data provide a unique data source in spatial epidemiology. Clustering of acute myocardial infarction occurs in Denmark. Clusters of acute myocardial infarction are associated with low socioeconomic position. Abstract: Objectives: To examine the geographical patterns in AMI and characterize individual and neighborhood sociodemographic factors for persons living inside versus outside AMI clusters. Methods: The study population comprised 3, 515, 670 adults out of whom 74, 126 persons experienced an incident AMI (2005–2011). Kernel density estimation and global and local clustering methods were used to examine the geographical patterns in AMI. Median differences and frequency distributions of sociodemographic factors were calculated for persons living inside versus outside AMI clusters. Results: Global clustering of AMI occurred in Denmark. Throughout the country, 112 significant clusters with high risk of incident AMI were identified. The relative risk of AMI in significant clusters ranged from 1.45 to 47.43 (median=4.84). Individual and neighborhood socioeconomic position was markedly lower for persons living inside versus outside AMI clusters. Conclusions: AMI is geographically unequally distributed throughout Denmark and determinants of these geographical patterns might include individual- and neighborhood-level sociodemographic factors.