Social, Geographical and Income Inequality as Demonstrated by the Coronary Calcium Score: An Ecological Study in Sydney, Australia

Craig Peter Coorey (), Luke D. Knibbs and James Otton
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Craig Peter Coorey: School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
Luke D. Knibbs: Faculty of Medicine and Health, School of Public Health, The University of Sydney, Camperdown, Sydney, NSW 2050, Australia
James Otton: Department of Cardiology, Liverpool Hospital, Liverpool, NSW 2170, Australia

IJERPH, 2023, vol. 20, issue 9, 1-11

Abstract: Background: The coronary calcium score is a non-invasive biomarker of coronary artery disease. The concept of “arterial age” transforms the coronary calcium score to an expected age based on the degree of coronary atherosclerosis. This study aimed to investigate the relationship of socioeconomic status with the burden of coronary artery disease within Sydney, Australia. Methods: This was an ecological study at the postcode level of patients aged 45 and above who had completed a CT coronary calcium scan within New South Wales (NSW), Australia from January 2012 to December 2020. Arterial age difference was calculated as arterial age minus chronological age. Socioeconomic data was obtained for median income, Index of Relative Socio-economic Advantage and Disadvantage (IRSAD) score and median property price. Linear regression was used for analysis. Results: There were 17,102 patients across 325 postcodes within NSW, comprising 9129 males with a median arterial age difference of 7 years and 7972 females with -9 years. Income, IRSAD score and property price each had an inverse relationship with arterial age difference ( p -values < 0.05). Conclusions: Income, socioeconomic status and local property prices are significantly correlated with premature coronary aging. Healthcare resource allocation and prevention should target the inequalities identified to reduce the burden of coronary artery disease.

Keywords: socioeconomic status; coronary artery calcium; arterial age; coronary artery disease; atherosclerosis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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