Perini Wilco, Agyemang Charles, Snijder Marieke B, Peters Ron J G, Kunst Anton E
1 Department of Public Health, Academic Medical Center of the University of Amsterdam, The Netherlands.
2 Department of Cardiology, Academic Medical Center of the University of Amsterdam, The Netherlands.
Scand J Public Health. 2018 Mar;46(2):204-213. doi: 10.1177/1403494817718906. Epub 2017 Jul 12.
European societies are becoming increasingly ethnically diverse. This may have important implications for socio-economic inequalities in health due to the often disadvantaged position of ethnic minority groups in both socio-economic status (SES) and disease, especially cardiovascular disease (CVD).
The aim of this study was to determine whether the socio-economic gradient of estimated CVD risk differs between ethnic groups.
Using the Healthy Life in an Urban Setting study, we obtained data on SES and CVD risk factors among participants from six ethnic backgrounds residing in Amsterdam. SES was measured using educational level and occupational level. CVD risk was estimated based on the occurrence of CVD risk factors using the Dutch version of the systematic coronary risk evaluation algorithm. Ethnic disparities in socio-economic gradients for estimated CVD risk were determined using the relative index of inequality (RII).
Among Dutch-origin men, the RII for estimated CVD risk according to educational level was 6.15% (95% confidence interval [CI] 4.35-7.96%), indicating that those at the bottom of the educational hierarchy had a 6.15% higher estimated CVD risk relative than those at the top. Among Dutch-origin women, the RII was 4.49% (CI 2.45-6.52%). The RII was lower among ethnic minority groups, ranging from 0.83% to 3.13% among men and -0.29% to 5.12% among women, indicating weaker associations among these groups. Results were similar based on occupational level.
Ethnic background needs to be considered in associations between SES and disease. The predictive value of SES varies between ethnic groups and may be quite poor for some groups.
欧洲社会的种族多样性日益增加。由于少数族裔群体在社会经济地位（SES）和疾病（尤其是心血管疾病，CVD）方面往往处于不利地位，这可能对健康方面的社会经济不平等产生重要影响。
本研究旨在确定不同种族群体之间估计的心血管疾病风险的社会经济梯度是否存在差异。
利用城市健康生活研究，我们获取了居住在阿姆斯特丹的六个种族背景参与者的社会经济地位和心血管疾病风险因素的数据。社会经济地位通过教育水平和职业水平来衡量。使用荷兰版的系统性冠状动脉风险评估算法，根据心血管疾病风险因素的发生情况来估计心血管疾病风险。使用不平等相对指数（RII）来确定估计的心血管疾病风险的社会经济梯度中的种族差异。
在荷兰裔男性中，根据教育水平估计的心血管疾病风险的RII为6.15%（95%置信区间[CI]4.35 - 7.96%），这表明教育层次底层的人估计的心血管疾病风险比顶层的人高6.15%。在荷兰裔女性中，RII为4.49%（CI 2.45 - 6.52%）。少数族裔群体中的RII较低，男性为0.83%至3.13%，女性为 - 0.29%至5.12%，这表明这些群体之间的关联较弱。基于职业水平的结果相似。
在社会经济地位与疾病的关联中需要考虑种族背景。社会经济地位的预测价值在不同种族群体之间有所不同，对某些群体可能相当低。
