Department of Public Health, Yonsei University Graduate School, Seoul, South Korea.
Division of Public Health, Department of Social Medicine, Graduate School of Medicine Osaka University, Osaka, Japan.
PLoS One. 2024 Aug 15;19(8):e0307040. doi: 10.1371/journal.pone.0307040. eCollection 2024.
Socioeconomic status (SES) has a considerable impact on cardiovascular health (CVH), which may differ by sex. We aimed to investigate sex-specific socioeconomic disparities in CVH among 31,141 individuals aged 25-64 years who participated in the cross-sectional 2007-2017 Korea National Health and Nutrition Survey (KNHANES) and the Life's Simple 7 metrics were used to define ideal CVH. Latent class analysis was used to estimate overall SES patterns. Logistic regression models were used to estimate sex-specific odds ratios (ORs) and 95% confidence interval (95% CI) for the likelihood of ideal CVH across SES classes, with the highest SES as the reference group. Four SES classes were identified: (1) low class with low education and material property (2.4%), (2) lower-medium class (10.1%) and (3) higher-medium class (43.7%) with increasing material affluence, and (4) high class with highest education and income (43.8%). Lower SES was associated with decreased ideal CVH among women; compared to their high SES counterparts, women with lowest SES were least likely to achieve ideal overall CVH (OR: 0.55, 95%CI: 0.43-0.71). Similar SES gradients in ideal overall CVH for men were also observed but it was less clear (OR (95%CI) for lowest SES: 0.83, 0.51-1.34). Low SES was associated with poorer achievement of ideal CVH with some sex-heterogeneities. Interventions that equalize the distribution of power and resources and targeted sex-specific approaches to empower low socioeconomic subgroups are warranted to prevent the transition from ideal to suboptimal cardiovascular health and to close socioeconomic disparities in CVH among Korean adults.
社会经济地位（SES）对心血管健康（CVH）有相当大的影响，而这种影响可能因性别而异。我们旨在调查 2007 年至 2017 年参加韩国全国健康和营养调查（KNHANES）的 31141 名 25-64 岁个体中 CVH 的性别特异性社会经济差异，并且使用 Life's Simple 7 指标来定义理想的 CVH。使用潜在类别分析来估计总体 SES 模式。使用逻辑回归模型估计 SES 类别中理想 CVH 的可能性的性别特异性比值比（OR）和 95%置信区间（95%CI），将最高 SES 作为参考组。确定了四个 SES 类别：（1）低 SES 类，教育程度和物质财产较低（2.4%），（2）较低 SES 类和（3）较高 SES 类（43.7%），物质财富不断增加，（4）高 SES 类，具有最高的教育程度和收入（43.8%）。较低的 SES 与女性理想 CVH 降低有关；与高 SES 女性相比，SES 最低的女性最不可能实现理想的整体 CVH（OR：0.55，95%CI：0.43-0.71）。还观察到男性理想总体 CVH 存在类似的 SES 梯度，但不太明显（SES 最低组的 OR（95%CI）：0.83，0.51-1.34）。低 SES 与较差的理想 CVH 实现相关，存在一些性别异质性。为了防止从理想的心血管健康向次优的心血管健康过渡，并缩小韩国成年人 CVH 中的社会经济差异，需要实施平等分配权力和资源的干预措施，并针对社会经济地位较低的亚组采取有针对性的赋权措施。
