Health inequalities in terms of myocardial infarction and all-cause mortality: a study with German claims data covering 2006 to 2015.

OBJECTIVES

International comparisons are suggesting that mortality inequalities may have changed in the last years, although not always into the same direction. Only a few studies examined myocardial infarction (MI). In our study, long-term developments of MI and all-cause mortality were considered by analysing social gradients by income.

METHODS

German claims data covering 2006 to 2015 (N = 2,474,448) were used with myocardial infarction and all-cause mortality as outcomes. Socio-economic position was depicted by individual income. Health inequalities were measured by hazard ratios between and within income groups for 10 consecutive calendar years.

RESULTS

In men, income gradients of MI and all-cause mortality were decreasing. In women, no income gradients emerged for MI, and they disappeared in mortality. In men, hazard ratios of MI and mortality decreased in the intermediate and in the lowest income thirds, thus leading to a reduction of MI-related health inequalities.

CONCLUSIONS

Income inequalities in terms of myocardial infarction and of mortality have narrowed in men, and those in the lowest income third were profiting most. No such changes were observed in women.