SOCIOECONOMIC-STATUS AND CORONARY HEART-DISEASE RISK FACTOR TRENDS - THE MINNESOTA-HEART-SURVEY

Background. Socioeconomic status (SES) indicators including education, income, and occupation are associated with coronary heart disease (CH D) risk factors, morbidity, and mortality. In most industrialized nati ons, individuals with less education, lower income, and blue collar oc cupations have the highest CHD rates. It is suggested by some that the se differences by SES are increasing even as age-adjusted CHD mortalit y declines. Methods and Results. The Minnesota Heart Survey includes m easurement of CHD risk factors and behaviors in population-based sampl es of Minneapolis-St. Paul adults aged 25 to 74 years in 1980 to 1982 (N=3243) and 1985 to 1987 (N=4538). Education was significantly and in versely related to blood pressure, cigarette smoking, body mass index, and a summary risk score for both men and women. Serum cholesterol wa s inversely related to education in women but not in men. Education wa s positively associated with leisure physical activity and health know ledge. Associations with household income were less consistent in magn itude and direction. Risk characteristics improved significantly betwe en the 1980 to 1982 and 1985 to 1987 surveys. These changes were simil ar across education and household income levels. Conclusions. Improvem ent in CHD risk factors over time unrelated to education or income sug gests that population-wide factors such as improved health knowledge, availability of healthy food items, hypertension treatment, and restri ctions on cigarette smoking are operating beneficially in all SES grou ps. Although the SES gradient in risk factors is not increasing, it re mains substantial and indicates directions for future prevention effor ts.