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Re-look at socioeconomic inequalities in stroke prevalence among urban Chinese: is the inflexion approaching?

Background The present association between socioeconomic status (SES) and stroke is positive in developing communities, but it is negative in developed countries where a positive SES-stroke relationship was recorded several decades ago. We hypothesized that the SES-stroke relationship in developing... Full description

Journal Title: BMC Public Health 2018, Vol.18
Main Author: Li, Shenghua
Other Authors: Xu, Fei , He, Jing , Wang, Zhiyong , Xiong, Yaqing , Chen, Daowen
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: E-ISSN: 14712458 ; DOI: 10.1186/s12889-018-5279-y
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title: Re-look at socioeconomic inequalities in stroke prevalence among urban Chinese: is the inflexion approaching?
format: Article
creator:
  • Li, Shenghua
  • Xu, Fei
  • He, Jing
  • Wang, Zhiyong
  • Xiong, Yaqing
  • Chen, Daowen
subjects:
  • China
  • Medical Records
  • Developed Countries
  • Population
  • Socioeconomic Factors
  • Stroke
  • Inequalities
  • Trends
  • Studies
  • Mortality
  • Economic Development
  • Questionnaires
  • Nutrition
  • Public Health
  • Socio-Economic Aspects
  • Socioeconomics
  • Urban Areas
  • Educational Attainment
  • Urban Areas
  • Economic Development
  • Developmental Stages
  • Adults
  • Gross Domestic Product–GDP
  • Urban Areas
  • Stroke
  • Prevalence
  • Socioeconomic Status
  • Family Average Income
ispartof: BMC Public Health, 2018, Vol.18
description: Background The present association between socioeconomic status (SES) and stroke is positive in developing communities, but it is negative in developed countries where a positive SES-stroke relationship was recorded several decades ago. We hypothesized that the SES-stroke relationship in developing societies mirrors the trajectory of the Western countries at some stage of economic development. This study aimed to examine whether this inflexion is approaching in China. Methods This study comprises of two cross-sectional surveys conducted in the same urban areas of Nanjing, China in 2000 (S2000) and 2011 (S2011) using the same selection criteria (i.e., aged≥35 years) and sampling approach. Physician-diagnosed stroke was the outcome event, while family average income (FAI) was the explanatory variable and tertiled in our anlaysis. Mixed-effects models were used to examine the FAI-stroke association. Results Overall, 19,861 (response rate = 90.1%) and 7824 (response rate = 82.8%) participants participated in the S2000 and S2011, respectively. The prevalence of stroke increased by 2.5-folds (95%CI = 2.2, 2.9) from 2000 (2.1%, 95%CI = 1.9%, 2.3%) to 2011 (5.1%, 95%CI = 4.6%, 5.6%) (p 
language: eng
source:
identifier: E-ISSN: 14712458 ; DOI: 10.1186/s12889-018-5279-y
fulltext: fulltext_linktorsrc
issn:
  • 14712458
  • 1471-2458
url: Link


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titleRe-look at socioeconomic inequalities in stroke prevalence among urban Chinese: is the inflexion approaching?
creatorLi, Shenghua ; Xu, Fei ; He, Jing ; Wang, Zhiyong ; Xiong, Yaqing ; Chen, Daowen
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identifierE-ISSN: 14712458 ; DOI: 10.1186/s12889-018-5279-y
subjectChina ; Medical Records ; Developed Countries ; Population ; Socioeconomic Factors ; Stroke ; Inequalities ; Trends ; Studies ; Mortality ; Economic Development ; Questionnaires ; Nutrition ; Public Health ; Socio-Economic Aspects ; Socioeconomics ; Urban Areas ; Educational Attainment ; Urban Areas ; Economic Development ; Developmental Stages ; Adults ; Gross Domestic Product–GDP ; Urban Areas ; Stroke ; Prevalence ; Socioeconomic Status ; Family Average Income
descriptionBackground The present association between socioeconomic status (SES) and stroke is positive in developing communities, but it is negative in developed countries where a positive SES-stroke relationship was recorded several decades ago. We hypothesized that the SES-stroke relationship in developing societies mirrors the trajectory of the Western countries at some stage of economic development. This study aimed to examine whether this inflexion is approaching in China. Methods This study comprises of two cross-sectional surveys conducted in the same urban areas of Nanjing, China in 2000 (S2000) and 2011 (S2011) using the same selection criteria (i.e., aged≥35 years) and sampling approach. Physician-diagnosed stroke was the outcome event, while family average income (FAI) was the explanatory variable and tertiled in our anlaysis. Mixed-effects models were used to examine the FAI-stroke association. Results Overall, 19,861 (response rate = 90.1%) and 7824 (response rate = 82.8%) participants participated in the S2000 and S2011, respectively. The prevalence of stroke increased by 2.5-folds (95%CI = 2.2, 2.9) from 2000 (2.1%, 95%CI = 1.9%, 2.3%) to 2011 (5.1%, 95%CI = 4.6%, 5.6%) (p < 0.01). Compared with the lower FAI category, the positive association between stroke prevalence and the higher FAI group decreased from 1.99 (95%CI = 1.55, 2.56) in 2000 to 1.49 (95%CI = 1.09, 2.03) in 2011 after control for potential confounders. A similar pattern was also observed for the middle FAI group (1.60, 95% CI = 1.23, 2.08 in 2000 vs. 1.37, 95%CI = 1.01, 1.88 in 2011). Conclusions This study revealed that socioeconomic inequalities in stroke were diminishing in regional China during the recent 11-year period, although the SES-stroke association was still positive. Tailored intervention against stroke should currently target on SES-vulnerable people.
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titleRe-look at socioeconomic inequalities in stroke prevalence among urban Chinese: is the inflexion approaching?
descriptionBackground The present association between socioeconomic status (SES) and stroke is positive in developing communities, but it is negative in developed countries where a positive SES-stroke relationship was recorded several decades ago. We hypothesized that the SES-stroke relationship in developing societies mirrors the trajectory of the Western countries at some stage of economic development. This study aimed to examine whether this inflexion is approaching in China. Methods This study comprises of two cross-sectional surveys conducted in the same urban areas of Nanjing, China in 2000 (S2000) and 2011 (S2011) using the same selection criteria (i.e., aged≥35 years) and sampling approach. Physician-diagnosed stroke was the outcome event, while family average income (FAI) was the explanatory variable and tertiled in our anlaysis. Mixed-effects models were used to examine the FAI-stroke association. Results Overall, 19,861 (response rate = 90.1%) and 7824 (response rate = 82.8%) participants participated in the S2000 and S2011, respectively. The prevalence of stroke increased by 2.5-folds (95%CI = 2.2, 2.9) from 2000 (2.1%, 95%CI = 1.9%, 2.3%) to 2011 (5.1%, 95%CI = 4.6%, 5.6%) (p < 0.01). Compared with the lower FAI category, the positive association between stroke prevalence and the higher FAI group decreased from 1.99 (95%CI = 1.55, 2.56) in 2000 to 1.49 (95%CI = 1.09, 2.03) in 2011 after control for potential confounders. A similar pattern was also observed for the middle FAI group (1.60, 95% CI = 1.23, 2.08 in 2000 vs. 1.37, 95%CI = 1.01, 1.88 in 2011). Conclusions This study revealed that socioeconomic inequalities in stroke were diminishing in regional China during the recent 11-year period, although the SES-stroke association was still positive. Tailored intervention against stroke should currently target on SES-vulnerable people.
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titleRe-look at socioeconomic inequalities in stroke prevalence among urban Chinese: is the inflexion approaching?
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abstractBackground The present association between socioeconomic status (SES) and stroke is positive in developing communities, but it is negative in developed countries where a positive SES-stroke relationship was recorded several decades ago. We hypothesized that the SES-stroke relationship in developing societies mirrors the trajectory of the Western countries at some stage of economic development. This study aimed to examine whether this inflexion is approaching in China. Methods This study comprises of two cross-sectional surveys conducted in the same urban areas of Nanjing, China in 2000 (S2000) and 2011 (S2011) using the same selection criteria (i.e., aged≥35 years) and sampling approach. Physician-diagnosed stroke was the outcome event, while family average income (FAI) was the explanatory variable and tertiled in our anlaysis. Mixed-effects models were used to examine the FAI-stroke association. Results Overall, 19,861 (response rate = 90.1%) and 7824 (response rate = 82.8%) participants participated in the S2000 and S2011, respectively. The prevalence of stroke increased by 2.5-folds (95%CI = 2.2, 2.9) from 2000 (2.1%, 95%CI = 1.9%, 2.3%) to 2011 (5.1%, 95%CI = 4.6%, 5.6%) (p < 0.01). Compared with the lower FAI category, the positive association between stroke prevalence and the higher FAI group decreased from 1.99 (95%CI = 1.55, 2.56) in 2000 to 1.49 (95%CI = 1.09, 2.03) in 2011 after control for potential confounders. A similar pattern was also observed for the middle FAI group (1.60, 95% CI = 1.23, 2.08 in 2000 vs. 1.37, 95%CI = 1.01, 1.88 in 2011). Conclusions This study revealed that socioeconomic inequalities in stroke were diminishing in regional China during the recent 11-year period, although the SES-stroke association was still positive. Tailored intervention against stroke should currently target on SES-vulnerable people.
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