Community Structure and Cardiovascular Mortality Trends

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Study Classification

OBSERVATIONAL

Study Start Date

1989-06-30

Study Completion Date

1993-05-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

To assess the relationship of community socioeconomic (SE) structure to cardiovascular disease and all-cause mortality trends in the United States.

Related Clinical Trials

Explore similar clinical trials based on study characteristics and research focus.

Effects of Neighborhood SES on Coronary Heart Disease Burden in Communities - Ancillary to ARIC

NCT00106951

Cardiovascular Diseases Coronary Disease Heart Diseases

COMPLETED

Neighborhood-Level Influences on All-Cause Mortality

NCT00031252

Cardiovascular Diseases Heart Diseases

COMPLETED

Life Course Socioeconomic Status, Social Context and Cardiovascular Disease

NCT00014833

Atherosclerosis Coronary Disease Cardiovascular Diseases

COMPLETED

Cardiovascular Disease Knowledge/Morbidity--Socioeconomic Cohort Outcomes

NCT00005480

Cardiovascular Diseases Heart Diseases

COMPLETED

Race, Class, and Gender--Studies of Health Effects

NCT00005443

Cardiovascular Diseases Heart Diseases Hypertension

COMPLETED

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

BACKGROUND:

Socioeconomic structure refers to aspects of communities -- their industries, physical resources, occupational and income distributions -- that create the conditions for change in health-related exposures, behaviors, and availability of quality medical care. Preliminary studies suggest growing inequalities in ischemic heart disease mortality in communities at different levels of socioeconomic structure that probably reflect both differences in timing of onset of decline and rate of decline of mortality. Despite the beginning of a national decline of ischemic heart disease mortality for white men in the middle 1960's, some communities only began the decline some years later, at which time the national decline accelerated. Late declining communities were more likely to be nonmetropolitan and in the South. Further analyses showed that the onset of decline was strongly related to measures of socioeconomic structure, and that income-related characteristics could account for much of the previously observed metropolitan differential. Another study showed that the decline of ischemic heart disease in both white men and women has been greater in county groups with occupational structures characterized by higher levels of white collar employment. The trend toward greater relative geographic inequality of mortality appears to be stronger for ischemic heart disease than for stroke, all cardiovascular disease or all-cause mortality. Prevention strategies should take account of these processes not only to achieve a more equitable distribution of health but to target populations with the greatest excess risk available for reduction.

DESIGN NARRATIVE:

Several analyses were conducted using mortality data from the National Center for Health Statistics and population and socioeconomic data from the Census Bureau. The onset of decline of ischemic heart disease in white women and Black men was analyzed in relation to geographic region, metropolitan status, and socioeconomic structure. The association between onset of decline of ischemic heart disease and its rate of decline was studied. The relationship of occupational structure and other aspects of socioeconomic structure to the rate of decline of ischemic heart disease mortality in Blacks and whites was quantified by age. Geographic variations in levels and trends of stroke mortality were described in relation to socioeconomic structure. The associations of socioeconomic structure, cardiovascular disease risk factors, blood pressure treatment, and mortality were quantified in geographic areas sampled in the National Health and Nutrition Examination Survey (NHANES). Socioeconomic structure-mortality trend associations for ischemic heart disease and stroke were compared to associations for all cardiovascular disease, all-cause and non-specific causes. A detailed analysis was made of socioeconomic structure-mortality associations in the United States South with special attention to impact on Black/white mortality differentials.