Format

Send to

Choose Destination
Mayo Clin Proc. 2008 Jun;83(6):663-9. doi: 10.4065/83.6.663.

Neighborhood income and individual education: effect on survival after myocardial infarction.

Author information

1
Department of Health Sciences Research, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.

Erratum in

  • Mayo Clin Proc. 2008 Aug;83(8):962.

Abstract

OBJECTIVE:

To evaluate the association of neighborhood-level income and individual-level education with post-myocardial infarction (MI) mortality in community patients.

PARTICIPANTS AND METHODS:

From November 1, 2002, through May 31, 2006, 705 (mean+/-SD age, 69+/-15 years; 44% women) residents of Olmsted County, MN, who experienced an MI meeting standardized criteria were prospectively enrolled and followed up. The neighborhood's median household income was estimated by census tract data; education was self-reported. Demographic and clinical variables were obtained from the medical records.

RESULTS:

Living in a less affluent neighborhood and having a low educational level were both associated with older age and more comorbidity. During follow-up (median, 13 months), 155 patients died. Neighborhood income (hazard ratio [HR], 2.10; 95% confidence interval [CI], 1.42-3.12; for lowest [median, $34,205] vs highest [median, $60,652] tertile) and individual education (HR, 2.21; 95% CI, 1.47-3.32; for <12 vs >12 years) were independently associated with mortality risk. Adjustment for demographics and various post-MI prognostic indicators attenuated these estimates, yet excess risk persisted for low neighborhood income (HR, 1.62; 95% CI, 1.08-2.45). Modeled as a continuous variable, each $10,000 increase in annual income was associated with a 10% reduction in mortality risk (adjusted HR, 0.90; 95% CI, 0.82-0.99).

CONCLUSION:

In this geographically defined cohort of patients with MI, low individual education and poor neighborhood income were associated with a worse clinical presentation. Poor neighborhood income was a powerful predictor of mortality even after controlling for a variety of potential confounding factors. These data confirm the socioeconomic disparities in health after MI.

PMID:
18533083
PMCID:
PMC2650487
DOI:
10.4065/83.6.663
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center