International Journal of Public Health (May 2021)
Educational Level, but Not Income or Area Deprivation, is Related to Macrovascular Disease: Results From Two Population-Based Cohorts in Germany
- Violetta Ptushkina,
- Violetta Ptushkina,
- Esther Seidel-Jacobs,
- Esther Seidel-Jacobs,
- Werner Maier,
- Werner Maier,
- Sabine Schipf,
- Sabine Schipf,
- Henry Völzke,
- Henry Völzke,
- Henry Völzke,
- Marcello Ricardo Paulista Markus,
- Marcello Ricardo Paulista Markus,
- Marcello Ricardo Paulista Markus,
- Matthias Nauck,
- Matthias Nauck,
- Christa Meisinger,
- Christa Meisinger,
- Annette Peters,
- Annette Peters,
- Christian Herder,
- Christian Herder,
- Christian Herder,
- Lars Schwettmann,
- Lars Schwettmann,
- Marcus Dörr,
- Marcus Dörr,
- Stephan B. Felix,
- Stephan B. Felix,
- Michael Roden,
- Michael Roden,
- Michael Roden,
- Wolfgang Rathmann,
- Wolfgang Rathmann
Affiliations
- Violetta Ptushkina
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes, Research at Heinrich-Heine-University, Düsseldorf, Germany
- Violetta Ptushkina
- German Center for Diabetes Research (DZD e.V.), Partner Düsseldorf, München-Neuherberg, Germany
- Esther Seidel-Jacobs
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes, Research at Heinrich-Heine-University, Düsseldorf, Germany
- Esther Seidel-Jacobs
- German Center for Diabetes Research (DZD e.V.), Partner Düsseldorf, München-Neuherberg, Germany
- Werner Maier
- German Center for Diabetes Research (DZD e.V.), Partner Düsseldorf, München-Neuherberg, Germany
- Werner Maier
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), München-Neuherberg, Germany
- Sabine Schipf
- German Center for Diabetes Research (DZD e.V.), Partner Düsseldorf, München-Neuherberg, Germany
- Sabine Schipf
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- Henry Völzke
- German Center for Diabetes Research (DZD e.V.), Partner Düsseldorf, München-Neuherberg, Germany
- Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- Henry Völzke
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Marcello Ricardo Paulista Markus
- German Center for Diabetes Research (DZD e.V.), Partner Düsseldorf, München-Neuherberg, Germany
- Marcello Ricardo Paulista Markus
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Marcello Ricardo Paulista Markus
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
- Matthias Nauck
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- Christa Meisinger
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, München-Neuherberg, Germany
- Christa Meisinger
- Chair of Epidemiology, University of Augsburg at University Hospital of Augsburg, Augsburg, Germany
- Annette Peters
- German Center for Diabetes Research (DZD e.V.), Partner Düsseldorf, München-Neuherberg, Germany
- Annette Peters
- 0Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), München-Neuherberg, Germany
- Christian Herder
- German Center for Diabetes Research (DZD e.V.), Partner Düsseldorf, München-Neuherberg, Germany
- Christian Herder
- 1Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
- Christian Herder
- 2Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
- Lars Schwettmann
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), München-Neuherberg, Germany
- Lars Schwettmann
- 3Department of Economics, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- Marcus Dörr
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Marcus Dörr
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
- Stephan B. Felix
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Stephan B. Felix
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
- Michael Roden
- German Center for Diabetes Research (DZD e.V.), Partner Düsseldorf, München-Neuherberg, Germany
- Michael Roden
- 1Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
- Michael Roden
- 2Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
- Wolfgang Rathmann
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes, Research at Heinrich-Heine-University, Düsseldorf, Germany
- Wolfgang Rathmann
- German Center for Diabetes Research (DZD e.V.), Partner Düsseldorf, München-Neuherberg, Germany
- DOI
- https://doi.org/10.3389/ijph.2021.633909
- Journal volume & issue
-
Vol. 66
Abstract
Objectives: An inverse relationship between education and cardiovascular risk has been described, however, the combined association of education, income, and neighborhood socioeconomic status with macrovascular disease is less clear. The aim of this study was to evaluate the association of educational level, equivalent household income and area deprivation with macrovascular disease in Germany.Methods: Cross-sectional data from two representative German population-based studies, SHIP-TREND (n = 3,731) and KORA-F4 (n = 2,870), were analyzed. Multivariable logistic regression models were applied to estimate odds ratios and 95% confidence intervals for the association between socioeconomic determinants and macrovascular disease (defined as self-reported myocardial infarction or stroke).Results: The study showed a higher odds of prevalent macrovascular disease in men with low and middle educational level compared to men with high education. Area deprivation and equivalent income were not related to myocardial infarction or stroke in any of the models.Conclusion: Educational level, but not income or area deprivation, is significantly related to the macrovascular disease in men. Effective prevention of macrovascular disease should therefore start with investing in individual education.
Keywords
