Department of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical Private University, Oberndorf, Austria.
Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Cent Eur J Public Health. 2024 Mar;32(1):25-30. doi: 10.21101/cejph.a7818.
The global burden of chronic diseases, including cardiovascular disease, remains a significant public health challenge. The Life's Simple 7 (LS7) score was developed as a tool to evaluate cardiovascular health behaviours and habits and identify high-risk individuals. The present study aimed to assess the distribution of LS7 scores among educational strata.
The study population consisted of 3,383 asymptomatic individuals screened for colorectal cancer at a single centre in Austria. We split patients into lower (n = 1,055), medium (n = 1,997), and higher (n = 331) education, based on the International Standard Classification of Education (ISCED). Cox regression models were utilized to determine the association between education and mortality over a median follow-up period of 7 years.
Individuals with higher educational status had a significantly higher prevalence of ideal cardiovascular health metrics, as defined by the LS7 score, compared to those with medium and lower educational status: n = 94 (28%) vs. n = 347 (17%) and n = 84 (8%), respectively, (p < 0.001). In the Cox regression analysis, both medium (HR = 0.61, 95% CI: 0.43-0.84, p < 0.001) and higher educational status (HR = 0.44, 95% CI: 0.19-1.01, p = 0.06) were associated with all-cause mortality, as was the LS7.
Our findings highlight a significant association between lower educational status and poorer cardiovascular health, as assessed by LS7, which persisted even after multivariable adjustment. Additionally, both educational status and LS7 were associated with increased mortality, underscoring the significance of our results. These findings have important implications for public health, as screening and prevention strategies may need to be tailored to meet the diverse educational backgrounds of individuals, given the higher prevalence of unhealthy lifestyle behaviours among those with lower educational status.
慢性病（包括心血管疾病）的全球负担仍然是一个重大的公共卫生挑战。Life's Simple 7（LS7）评分是一种用于评估心血管健康行为和习惯并识别高危个体的工具。本研究旨在评估 LS7 评分在教育阶层中的分布情况。
研究人群由奥地利一家单一中心筛查的 3383 名无症状结直肠癌患者组成。我们根据国际标准教育分类（ISCED）将患者分为低（n = 1055）、中（n = 1997）和高（n = 331）教育程度。我们使用 Cox 回归模型来确定教育程度与中位随访 7 年后的死亡率之间的关系。
与中低教育程度者相比，教育程度较高者具有更高的 LS7 评分理想心血管健康指标的患病率：n = 94（28%）、n = 347（17%）和 n = 84（8%）（p < 0.001）。在 Cox 回归分析中，中教育程度（HR = 0.61，95%CI：0.43-0.84，p < 0.001）和高教育程度（HR = 0.44，95%CI：0.19-1.01，p = 0.06）与全因死亡率均相关，LS7 也是如此。
我们的研究结果表明，LS7 评估的较低教育程度与较差的心血管健康状况之间存在显著关联，即使在多变量调整后仍然存在。此外，教育程度和 LS7 与死亡率增加均相关，这凸显了我们研究结果的重要性。这些发现对公共卫生具有重要意义，因为鉴于较低教育程度者中不健康生活方式行为的发生率较高，筛查和预防策略可能需要根据个人的不同教育背景进行调整。
