Socioeconomic Status and Cardiovascular Risks in Middle-Aged Chinese Adults in General Population

Dr Wong, Janet Yuen Ha   (Principal Investigator (PI))

Dr Chan Kelvin Ki Wan   (Co-Investigator)

Dr Fong Daniel Yee Tak   (Co-Investigator)

24

2015-04-01

72491

Socioeconomic Status and Cardiovascular Risks in Middle-Aged Chinese Adults in General Population

Cardiovascular Risks, Middle-Aged, Psychological Distress, Socioeconomic Status

Nursing

201409176050

Small Project Funding

2014

Completed

Introduction: Cardiovascular disease (CVD) refers to a group of disorders associated with the heart and blood vessels. It has been listed as one of the four main non-communicable diseases worldwide. CVD is the main cause of death in the globe, accounting 30% of all global deaths in 2008 [1]. Hence, there has been much effort in understanding the aetiology of the disease for formulating preventive measures. There has been growing international concern about variations in cardiovascular diseases related socioeconomic status (SES) [2, 3]. The effect of SES on cardiovascular diseases cannot be explained by poverty or lack of food alone, but it also includes access to health care services and health inequalities. SES can be classified into objective SES with the considerations of education level, occupation, and household income, and subjective SES. Previous study demonstrated that subjective SES increased psychological distress and also tended to play a role in leading to cardiovascular diseases [4]. Key Issues and Problems: 1. Lack of risk prediction model for cardiovascular risks with the consideration of SES in Chinese In the traditional Framingham Heart Study in US, the calculation of risk prediction for cardiovascular risks was based on the risk factors including age, gender, blood pressure, glucose level and cholesterol level [5]. However, socioeconomic status was not considered in the model and had not validated in Chinese. Another well-known CVD risk prediction model is QRISK2 in UK, which has included ethnic groups, including Chinese for the calculation. However, the model may not be representative of Chinese living in Chinese communities because Chinese immigrants may be influenced by environmental factors such as stress of being an ethnic minority, lifestyle, and food availability [6]. Wu et al. [7] recently developed a predictive model for estimating the 10-year risk of CVD in Chinese populations based on a large sample of 9,903 Chinese individuals [7]. However, SES was not considered in the model. Therefore, it is worthy to examine whether SES will affect CVDs in Chinese. 2. There is no study investigated the relationship between subjective SES and cardiovascular diseases in Chinese Emerging research findings showed that low subjective SES was associated with increased cardiovascular risks [8]. Hong Kong has a high Gini coefficient (0.537) with ranking 11th in the world. Although there are not many people with absolute poverty in Hong Kong, including lack of food, housing and shelter, but the relative poverty of feeling poor compared to the neighbours may be high due to the high and growing Gini coefficient in Hong Kong [9]. The wealth and income disparity in the city may induce more low subjective SES and psychological distress in low-income individuals and families. Purpose: This study aims to examine and compare the associations among objective SES, subjective SES and cardiovascular risks in Chinese by a cross-sectional study. Objectives: 1. To determine and compare the cardiovascular risks in individuals with high and low objective SES 2. To determine and compare the cardiovascular risks in individuals with low objective and low subjective SES