Community Structure and Cardiovascular Mortality Trends

February 4, 2016 updated by: University of North Carolina, Chapel Hill
To assess the relationship of community socioeconomic (SE) structure to cardiovascular disease and all-cause mortality trends in the United States.

Study Overview

Status

Completed

Conditions

Detailed Description

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.

Study Type

Observational

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

No older than 100 years (Child, Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Male

Description

No eligibility criteria

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of North Carolina, Chapel Hill

Collaborators

National Heart, Lung, and Blood Institute (NHLBI)

Investigators

  • Principal Investigator: Steven Wing, University of North Carolina, Chapel Hill

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

June 1, 1989

Primary Completion (Actual)

May 1, 1993

Study Completion (Actual)

May 1, 1993

Study Registration Dates

First Submitted

May 25, 2000

First Submitted That Met QC Criteria

May 25, 2000

First Posted (Estimate)

May 26, 2000

Study Record Updates

Last Update Posted (Estimate)

February 5, 2016

Last Update Submitted That Met QC Criteria

February 4, 2016

Last Verified

February 1, 2016

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 1126
  • R01HL042320 (U.S. NIH Grant/Contract)

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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