Socioeconomic inequalities in acute myocardial infarction incidence in migrant groups: has the epidemic arrived? Analysis of nation-wide data. Issue 3 (15th November 2013)

• Record Type: Journal Article
• Authors: Agyemang, C; van Oeffelen, A A M; Bots, M L; Stronks, K; Vaartjes, I
• Is Part Of: Heart. Volume 100:Issue 3(2014)
• Page Start: 239
• Page End: 246
• Publication Date: 2013-11-15
• Subjects: MYOCARDIAL ISCHAEMIA AND INFARCTION (IHD); Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2013-304721
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objectives: We assessed socioeconomic inequalities in relation to acute myocardial infarction (AMI) incidence among major ethnic groups in The Netherlands. Methods: A nationwide register-based cohort study was conducted (n=2 591 170) between 1 January 1998 and 31 December 2007 among ethnic Dutch and migrant groups from Suriname, Netherlands Antilles, Indonesia, Morocco and Turkey. Standardised household disposable income was used as a proxy for socioeconomic position. Cox proportional hazard models were used to estimate the socioeconomic inequalities in AMI incidence. Results: Among ethnic Dutch, the AMI incidence was higher in the low-income group than in the high-income group: adjusted HRs were 2.05 (95% CI 2.00 to 2.10) for men and 2.33 (95% CI 2.23 to 2.43) for women. Importantly, similar socioeconomic inequalities in AMI incidence were also observed in all minority groups, with the low socioeconomic group having a higher AMI incidence than the high socioeconomic group: adjusted HR ranging from 2.07 (95% CI 1.26 to 3.40) in Moroccans to 2.73 (95% CI 1.55 to 4.80) in Antilleans in men; and from 2.17 (95% CI 1.74 to 2.71) in Indonesians to 3.88 (95% CI 2.36 to 6.38) in Turks in women. Conclusions: Our findings demonstrate socioeconomic inequalities in AMI incidence in migrant groups and suggest a convergence towards the Dutch general population. If the AMI incidence rates of the low socioeconomic group could be reduced to the level of the high socioeconomic group, this would represent a major public health improvement for all ethnic groups.