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dc.contributor.authorAriansen, Inger
dc.contributor.authorStrand, Bjørn Heine
dc.contributor.authorKjøllesdal, Marte Karoline Råberg
dc.contributor.authorSteingrímsdóttir, Ólöf Anna
dc.contributor.authorMortensen, Laust Hvas
dc.contributor.authorStigum, Hein
dc.contributor.authorGraff-Iversen, Sidsel
dc.contributor.authorNæss, Øyvind
dc.date.accessioned2019-05-10T11:28:55Z
dc.date.available2019-05-10T11:28:55Z
dc.date.issued2019-01-28
dc.description.abstract<i>Aims</i>: Educational inequality in cardiovascular disease and in modifiable risk factors changes over time and between birth cohorts. We aimed to assess how cardiovascular disease risk factors mediate educational differences in premature cardiovascular disease mortality and how this varies over birth cohorts and sex.<p> <p><i>Methods</i>: We followed 360,008 40–45-year-olds born in the 1930s, 1940s or 1950s from Norwegian health examination surveys (1974–1997) for premature cardiovascular disease mortality. Cox proportional hazard and Aalen’s additive survival analyses provided hazard ratios and rate differences of excess deaths in participants with basic versus tertiary education.<p> <p><i>Results</i>: Relative educational differences in premature cardiovascular disease mortality were stable, whereas absolute differences narrowed from the 1930s to the 1950s cohorts; rate differences per 100 000 person years declined from 170 (95% confidence interval 117, 224) to 49 (36, 61) in men and from 60 (34, 85) to 23 (16, 29) in women. Cardiovascular disease risk factors attenuated rate differences by 69% in both cohorts in men, and in women by 102% in 1930s and 61% in 1950s cohorts. Smoking had the single strongest influence on the educational differences for men in all three cohorts, and for women in the two most recent cohorts.<p> <p><i>Conclusion</i>: Smoking appeared to be the driving force behind educational differences in premature cardiovascular disease mortality in the 1930s to 1950s birth cohorts for men and in the two recent birth cohorts for women. This suggests that strategies for smoking prevention and cessation might have the strongest impact for reducing educational inequality in premature cardiovascular disease mortality.<p>en_US
dc.descriptionAccepted manuscript version. Published version available at <a href=https://doi.org/10.1177/2047487319826274>https://doi.org/10.1177/2047487319826274. </a>en_US
dc.identifier.citationAriansen, I., Strand, B.H., Kjøllesdal, M.K., Steingrímsdóttir, O.A., Mortensen, L.H., Stigum, H. ... Næss, Ø. (2019). The educational gradient in premature cardiovascular mortality: Examining mediation by risk factors in cohorts born in the 1930s, 1940s and 1950s. <i>European Journal of Preventive Cardiology</i>. https://doi.org/10.1177/2047487319826274en_US
dc.identifier.cristinIDFRIDAID 1691376
dc.identifier.doi10.1177/2047487319826274
dc.identifier.issn2047-4873
dc.identifier.issn2047-4881
dc.identifier.urihttps://hdl.handle.net/10037/15280
dc.language.isoengen_US
dc.publisherSAGE Publicationsen_US
dc.relation.journalEuropean Journal of Preventive Cardiology
dc.relation.projectIDinfo:eu-repo/grantAgreement/RCN/BEDREHELSE/213788/Norway/Socioeconomic inequalities in cardiovascular disease risk over the life course and in different generations//en_US
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801en_US
dc.subjectVDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801en_US
dc.subjectCardiovascular diseasesen_US
dc.subjectmortalityen_US
dc.subjecthealth behaviouren_US
dc.subjecteducational statusen_US
dc.subjectsocioeconomic factorsen_US
dc.subjectcohort effecten_US
dc.titleThe educational gradient in premature cardiovascular mortality: Examining mediation by risk factors in cohorts born in the 1930s, 1940s and 1950sen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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