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Article: Age-period-cohort projections of ischaemic heart disease mortality by socio-economic position in a rapidly transitioning Chinese population

TitleAge-period-cohort projections of ischaemic heart disease mortality by socio-economic position in a rapidly transitioning Chinese population
Authors
Issue Date2013
PublisherPublic Library of Science. The Journal's web site is located at http://www.plosone.org/home.action
Citation
Plos One, 2013, v. 8 n. 4 How to Cite?
AbstractBackground:With economic development and population aging, ischaemic heart disease (IHD) is becoming a leading cause of mortality with widening inequalities in China. To forewarn the trends in China we projected IHD trends in the most economically developed part of China, i.e., Hong Kong.Methods:Based on sex-specific IHD mortality rates from 1976 to 2005, we projected mortality rates by neighborhood-level socio-economic position (i.e., low- or high-income groups) to 2020 in Hong Kong using Poisson age-period-cohort models with autoregressive priors.Results:In the low-income group, age-standardized IHD mortality rates among women declined from 33.3 deaths in 1976-1980 to 19.7 per 100,000 in 2016-2020 (from 55.5 deaths to 34.2 per 100,000 among men). The rates in the high-income group were initially higher in both sexes, particularly among men, but this had reversed by the end of the study periods. The rates declined faster for the high-income group than for the low-income group in both sexes. The rates were projected to decline faster in the high-income group, such that by the end of the projection period the high-income group would have lower IHD mortality rates, particularly for women. Birth cohort effects varied with sex, with a marked upturn in IHD mortality around 1945, i.e., for the first generation of men to grow up in a more economically developed environment. There was no such upturn in women. Birth cohort effects were the main drivers of change in IHD mortality rates.Conclusion:IHD mortality rates are declining in Hong Kong and are projected to continue to do so, even taking into account greater vulnerability for the first generation of men born into a more developed environment. At the same time social disparities in IHD have reversed and are widening, partly as a result of a cohort effect, with corresponding implications for prevention. © 2013 Wong et al.
Persistent Identifierhttp://hdl.handle.net/10722/183182
ISSN
2015 Impact Factor: 3.057
2015 SCImago Journal Rankings: 1.395
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWong, IOLen_HK
dc.contributor.authorCowling, BJen_HK
dc.contributor.authorLeung, GMen_HK
dc.contributor.authorSchooling, CMen_HK
dc.date.accessioned2013-05-15T01:47:12Z-
dc.date.available2013-05-15T01:47:12Z-
dc.date.issued2013en_HK
dc.identifier.citationPlos One, 2013, v. 8 n. 4en_HK
dc.identifier.issn1932-6203en_HK
dc.identifier.urihttp://hdl.handle.net/10722/183182-
dc.description.abstractBackground:With economic development and population aging, ischaemic heart disease (IHD) is becoming a leading cause of mortality with widening inequalities in China. To forewarn the trends in China we projected IHD trends in the most economically developed part of China, i.e., Hong Kong.Methods:Based on sex-specific IHD mortality rates from 1976 to 2005, we projected mortality rates by neighborhood-level socio-economic position (i.e., low- or high-income groups) to 2020 in Hong Kong using Poisson age-period-cohort models with autoregressive priors.Results:In the low-income group, age-standardized IHD mortality rates among women declined from 33.3 deaths in 1976-1980 to 19.7 per 100,000 in 2016-2020 (from 55.5 deaths to 34.2 per 100,000 among men). The rates in the high-income group were initially higher in both sexes, particularly among men, but this had reversed by the end of the study periods. The rates declined faster for the high-income group than for the low-income group in both sexes. The rates were projected to decline faster in the high-income group, such that by the end of the projection period the high-income group would have lower IHD mortality rates, particularly for women. Birth cohort effects varied with sex, with a marked upturn in IHD mortality around 1945, i.e., for the first generation of men to grow up in a more economically developed environment. There was no such upturn in women. Birth cohort effects were the main drivers of change in IHD mortality rates.Conclusion:IHD mortality rates are declining in Hong Kong and are projected to continue to do so, even taking into account greater vulnerability for the first generation of men born into a more developed environment. At the same time social disparities in IHD have reversed and are widening, partly as a result of a cohort effect, with corresponding implications for prevention. © 2013 Wong et al.en_HK
dc.languageengen_US
dc.publisherPublic Library of Science. The Journal's web site is located at http://www.plosone.org/home.actionen_HK
dc.relation.ispartofPLoS ONEen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titleAge-period-cohort projections of ischaemic heart disease mortality by socio-economic position in a rapidly transitioning Chinese populationen_HK
dc.typeArticleen_HK
dc.identifier.emailWong, IOL: iolwong@hku.hken_HK
dc.identifier.emailCowling, BJ: bcowling@hku.hken_HK
dc.identifier.emailLeung, GM: gmleung@hkucc.hku.hken_HK
dc.identifier.emailSchooling, CM: cms1@hkucc.hku.hken_HK
dc.identifier.authorityWong, IOL=rp01806en_HK
dc.identifier.authorityCowling, BJ=rp01326en_HK
dc.identifier.authorityLeung, GM=rp00460en_HK
dc.identifier.authoritySchooling, CM=rp00504en_HK
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1371/journal.pone.0061495en_HK
dc.identifier.pmid23593484-
dc.identifier.scopuseid_2-s2.0-84876132116en_HK
dc.identifier.hkuros214171en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84876132116&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume8en_HK
dc.identifier.issue4en_HK
dc.identifier.spagee61495en_US
dc.identifier.epagee61495en_US
dc.identifier.isiWOS:000317383200058-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridWong, IOL=55649985700en_HK
dc.identifier.scopusauthoridCowling, BJ=8644765500en_HK
dc.identifier.scopusauthoridLeung, GM=7007159841en_HK
dc.identifier.scopusauthoridSchooling, CM=12808565000en_HK

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