Skip to main content

Advertisement

SpringerLink
Log in

The Association of Lifetime Education with the Prevalence of Myocardial Infarction: An Analysis of the 2006 Behavioral Risk Factor Surveillance System

  • Published:
Journal of Community Health Aims and scope Submit manuscript

Abstract

Socioeconomic status is likely an independent risk factor for coronary heart disease but little research has been done in the United States to study this association in a nationally representative sample. We sought to determine the association between lifetime education and the prevalence of myocardial infarction (MI) among adults over the age of 39 in the US. A cross sectional study was conducted using the 2006 Behavioral Risk Factor Surveillance System (BRFSS). A multivariable logistic regression was performed. The analysis was conducted in 2008. Among respondents aged 40 years and older to the 2006 BRFSS survey those with less than a high school education had 3.09 (95% CI: 2.79–3.43) times the odds of having had an MI compared to college graduates. After adjusting for confounders, respondents with less than a high school education had 1.61 (95% CI: 1.41–1.83) times the odds of having had an MI compared to college graduates. Both those with a high school education and those who completed some college or technical school had 1.22 times the odds of having had an MI compared to college graduates after adjusting for confounders. This study suggests that education is a risk factor for MI. More national prospective studies are needed in the US to better understand the link between socioeconomic status and coronary heart disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Rosamond, W., Flegal, K., Furie, K., Go, A., Greenlund, K., Haase, N., et al. (2008). Heart disease and stroke statistics–2008 update: A report from the American heart association statistics committee and stroke statistics subcommittee. Circulation, 117(4), e25–e146.

    Article  PubMed  Google Scholar 

  2. Yusuf, S., Hawken, S., Ounpuu, S., Dans, T., Avezum, A., Lanas, F., et al. (2004). Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): Case–control study. Lancet, 364(9438), 937–952.

    Article  PubMed  Google Scholar 

  3. Wilson, P. W., D’Agostino, R. B., Levy, D., Belanger, A. M., Silbershatz, H., & Kannel, W. B. (1998). Prediction of coronary heart disease using risk factor categories. Circulation, 97(18), 1837–1847.

    CAS  PubMed  Google Scholar 

  4. Wilson, P. W. (1994). Established risk factors and coronary artery disease: The Framingham study. American Journal of Hypertension, 7(7 pt 2), 7S–12S.

    CAS  PubMed  Google Scholar 

  5. Hennekens, C. H. (1998). Increasing burden of cardiovascular disease: Current knowledge and future directions for research on risk factors. Circulation, 97(11), 1095–1102.

    CAS  PubMed  Google Scholar 

  6. Khot, U. N., Khot, M. B., Bajzer, C. T., Sapp, S. K., Ohman, E. M., Brener, S. J., et al. (2003). Prevalence of conventional risk factors in patients with coronary heart disease. Journal of the American Medical Association, 290(7), 898–904.

    Article  PubMed  Google Scholar 

  7. Kaplan, G. A., & Keil, J. E. (1993). Socioeconomic factors and cardiovascular disease: A review of the literature. Circulation, 88(4 pt 1), 1973–1978.

    CAS  PubMed  Google Scholar 

  8. Winkleby, M. A., Jatulis, D. E., Frank, E., & Fortmann, S. P. (1992). Socioeconomic status and health: How education, income, and occupation contribute to risk factors for cardiovascular disease. American Journal of Public Health, 82(6), 816–820.

    Article  CAS  PubMed  Google Scholar 

  9. Wannamethee, S. G., & Shaper, A. G. (1997). Socioeconomic status within social class and mortality: A prospective study in middle-aged British men. International Journal of Epidemiology, 26(3), 532–541.

    Article  CAS  PubMed  Google Scholar 

  10. Suadicani, P., Hein, H. O., & Gyntelberg, F. (1997). Strong mediators of social inequalities in risk of ischaemic heart disease: A six-year follow-up in the Copenhagen male study. International Journal of Epidemiology, 26(3), 516–522.

    Article  CAS  PubMed  Google Scholar 

  11. Strand, B. H., & Tverdal, A. (2004). Can cardiovascular risk factors and lifestyle explain the educational inequalities in mortality from ischaemic heart disease and from other heart diseases? 26 year follow up of 50,000 Norwegian men and women. Journal of Epidemiology and Community Health, 58(8), 705–709.

    Article  PubMed  Google Scholar 

  12. Morrison, C., Woodward, M., Leslie, W., & Tunstall-Pedoe, H. (1997). Effect of socioeconomic group on incidence of, management of, and survival after myocardial infarction and coronary death: Analysis of community coronary event register. British Medical Journal, 314(7080), 541–546.

    CAS  PubMed  Google Scholar 

  13. Lynch, J. W., Kaplan, G. A., Cohen, R. D., Tuomilehto, J., & Salonen, J. T. (1996). Do cardiovascular risk factors explain the relation between socioeconomic status, risk of all-cause mortality, cardiovascular mortality, and acute myocardial infarction? American Journal of Epidemiology, 144(10), 934–942.

    CAS  PubMed  Google Scholar 

  14. Andersen, I., Osler, M., Petersen, L., Gronbaek, M., & Prescott, E. (2003). Income and risk of ischaemic heart disease in men and women in a Nordic welfare country. International Journal of Epidemiology, 32(3), 367–374.

    Article  PubMed  Google Scholar 

  15. Albert, M. A., Glynn, R. J., Buring, J., & Ridker, P. M. (2006). Impact of traditional and novel risk factors on the relationship between socioeconomic status and incident cardiovascular events. Circulation, 114(24), 2619–2626.

    Article  PubMed  Google Scholar 

  16. Centers for disease control and prevention, National center for chronic disease prevention and health promotion. 2006 Behavioral risk surveillance system [Data file]. Retrieved from http://www.cdc.gov/brfss/technical_infodata/surveydata/2006.htm.

  17. Flood, V., Webb, K., Lazarus, R., & Pang, G. (2000). Use of self-report to monitor overweight and obesity in populations: Some issues for consideration. Australian and New Zealand Journal of Public Health, 24(1), 96–99.

    Article  CAS  PubMed  Google Scholar 

  18. Braveman, P. A., Cubbin, C., Egerter, S., Chideya, S., Marchi, K. S., Metzler, M., et al. (2005). Socioeconomic status in health research: One size does not fit all. Journal of the American Medical Association, 294(22), 2879–2888.

    Article  CAS  PubMed  Google Scholar 

  19. Suadicani, P., Hein, H. O., & Gyntelberg, F. (2001). Socioeconomic status and ischaemic heart disease mortality in middle-aged men: Importance of the duration of follow-up. The Copenhagen male study. International Journal of Epidemiology, 30(2), 248–255.

    Article  CAS  PubMed  Google Scholar 

  20. Marmot, M. G., Bosma, H., Hemingway, H., Brunner, E., & Stansfeld, S. (1997). Contribution of job control and other risk factors to social variations in coronary heart disease incidence. Lancet, 350(9073), 235–239.

    Article  CAS  PubMed  Google Scholar 

  21. Wilson, P. W., Garrison, R. J., Castelli, W. P., Feinleib, M., McNamara, P. M., & Kannel, W. B. (1980). Prevalence of coronary heart disease in the Framingham offspring study: Role of lipoprotein cholesterols. American Journal of Cardiology, 46(4), 649–654.

    Article  CAS  PubMed  Google Scholar 

  22. Lee, I. M., Cook, N. R., Gaziano, J. M., Gordon, D., Ridker, P. M., Manson, J. E., et al. (2005). Vitamin E in the primary prevention of cardiovascular disease and cancer: The Women’s health study: A randomized controlled trial. Journal of the American Medical Association, 294(1), 56–65.

    Article  CAS  PubMed  Google Scholar 

  23. Jousilahti, P., Salomaa, V., Rasi, V., Vahtera, E., & Palosuo, T. (2003). Association of markers of systemic inflammation, C reactive protein, serum amyloid A, and fibrinogen, with socioeconomic status. Journal of Epidemiology and Community Health, 57(9), 730–733.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, The Floating Hospital for Children, Tufts Medical Center, 800 Washington St., Box #14, Boston, MA, 02111, USA

    Michael J. Kelly

  2. Division of Biology and Medicine, Department of Community Health, Box G-S121, 121 South Main St, Providence, RI, 02912, USA

    Sherry Weitzen

Authors
  1. Michael J. Kelly
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sherry Weitzen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael J. Kelly.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kelly, M.J., Weitzen, S. The Association of Lifetime Education with the Prevalence of Myocardial Infarction: An Analysis of the 2006 Behavioral Risk Factor Surveillance System. J Community Health 35, 76–80 (2010). https://doi.org/10.1007/s10900-009-9189-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10900-009-9189-x

Keywords

Search

Navigation