Low control beliefs, classical coronary risk factors, and socio-economic differences in heart disease in older persons

H. Bosma, C. H. M. Van Jaarsveld, J. Tuinstra, R. Sanderman, A. V. Ranchor, J. Th. M. Van Eijk and G. I. J. M. Kempen

Social Science & Medicine, 2005, vol. 60, issue 4, 737-745

Abstract: The objective of this study was to examine whether it is through their low control beliefs that low socio-economic status groups have higher risks of heart disease, and to examine whether this mechanism is more substantial than and independent of the mechanism via classical coronary risk factors. In a population-based prospective cohort study, participants were selected from 27 general practices in the north-eastern part of The Netherlands. In 1993, there were 3888 men and women, 57 years and older, who were without prevalent heart disease. During the 5-year follow-up period, 287 cases of incident heart disease (acute myocardial infarction and/or congestive heart failure) were registered (7%). Persons with a low socio-economic status had higher risks of heart disease (RR = 1.45 (95% CI: 1.06 - 1.99)) compared with their high status counterparts. On average, 4 percent of the socio-economic differences were accounted for by the classical coronary risk factors (e.g. smoking, hypertension) compared with 30 percent by the control beliefs. The contribution of the latter was largely independent of the former. Our findings support the hypothesis that socio-economic inequalities in heart disease--at least in middle-aged and older persons--may be based upon differences in control beliefs, more than upon differences in smoking rates and other classical risk factors.

Keywords: Social; class; Heart; disease; Coronary; risk; factors; Perceived; control; The; Netherlands (search for similar items in EconPapers)
Date: 2005
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

Downloads: (external link)
http://www.sciencedirect.com/science/article/pii/S0277-9536(04)00285-0
Full text for ScienceDirect subscribers only

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:eee:socmed:v:60:y:2005:i:4:p:737-745

Ordering information: This journal article can be ordered from
http://www.elsevier.com/wps/find/supportfaq.cws_home/regional
http://www.elsevier. ... _01_ooc_1&version=01

Access Statistics for this article

Social Science & Medicine is currently edited by Ichiro (I.) Kawachi and S.V. (S.V.) Subramanian

More articles in Social Science & Medicine from Elsevier
Bibliographic data for series maintained by Catherine Liu ().