The Contribution of Material, Behavioral, Psychological, and Social-Relational Factors to Income-Related Disparities in Cardiovascular Risk Among Older Adults.
Chiyoung Lee, Qing Yang, Eun-Ok Im and 3 others
PMID 36036986WHAT IT FOUND
Lower income was linked to higher 10-year cardiovascular risk in Korean adults aged 65 to 74 years.
Social-relational factors were more closely associated with this gap in men of that age, and material factors in women.
Key findings
01Among adults aged 65 to 74 years, lower income was associated with higher relative risk of high cardiovascular risk: men in the lowest income group had 2.96 times the relative risk of men in the highest income group, and women in the lowest income group had 1.95 times the relative risk of women in the highest income group.
02For men aged 65 to 74 years, accounting for social-relational factors reduced the income-risk gap measure from 3.09 to 2.80, a 13.7% reduction; for women of the same age, accounting for material factors reduced it by 31.8%.
03Among adults aged 75 years or older, the income-risk trend was significant only for men, whose lowest income group had 5.29 times greater relative risk than the highest income group.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Cross-sectional survey data cannot show that income, social relationships, material factors or behaviours caused higher cardiovascular risk. People with a history of cardiovascular disease were excluded, and the sample was community-dwelling Korean adults, so findings may not apply to patients with existing disease or institutionalised older adults. Several factors were measured by one survey question, so they may not capture the full social or psychological situation. Missing data were filled with means or most common categories, which does not account for uncertainty in the filled values. The income-gap estimates had wide confidence intervals that overlapped substantially, so the size of each factor's contribution is imprecise.
The easy way to misread this
Do not conclude that improving social relationships, insurance access or exercise will lower cardiovascular risk. This cross-sectional survey shows associations, not cause and effect.