Leyland Alastair H
MRC Social and Public Health Sciences Unit, University of Glasgow, 4 Lilybank Gardens, Glasgow G12 8RZ, Scotland.
J Epidemiol Community Health. 2005 Sep;59(9):799-803. doi: 10.1136/jech.2005.034017.
To investigate whether occupational social class and area deprivation are independently associated with the prevalence of cardiovascular disease (CVD) conditions after adjustment for smoking status.
Stratified multistage random sample analysed using multilevel logistic regression.
8804 adults aged 18-74 at time of interview in 1998-1999, clustered in 312 small areas. The outcome considered was a self report of doctor diagnosis of one of a number of CVD conditions. The survey also provided information concerning the respondent's occupational social class and current smoking status. The Carstairs score (based on the 1991 census) was used to describe small area deprivation.
The gradient in CVD prevalence across individual social class was attenuated and became insignificant when area deprivation was considered. The aggregation of individual social class and smoking to the area level increased the correlation with disease prevalence at the individual level.
Although there is a relation between socioeconomic status and CVD prevalence in Scotland, the relation is dominated by area deprivation. When externally validated deprivation measures are not available, aggregated individual characteristics may show a contextual (as compared with compositional) relation.
在对吸烟状况进行调整后，调查职业社会阶层和地区贫困程度是否与心血管疾病（CVD）的患病率独立相关。
采用多水平逻辑回归分析分层多阶段随机样本。
1998 - 1999年访谈时年龄在18 - 74岁的8804名成年人，分为312个小区域。所考虑的结果是医生诊断出的多种心血管疾病之一的自我报告。该调查还提供了有关受访者职业社会阶层和当前吸烟状况的信息。使用卡斯尔斯评分（基于1991年人口普查）来描述小区域贫困程度。
当考虑地区贫困程度时，个体社会阶层中CVD患病率的梯度减弱且变得不显著。个体社会阶层和吸烟情况在地区层面的汇总增加了与个体层面疾病患病率的相关性。
虽然在苏格兰社会经济地位与CVD患病率之间存在关联，但这种关联主要由地区贫困程度主导。当没有经过外部验证的贫困衡量指标时，汇总的个体特征可能显示出一种背景性（与构成性相对）关系。
