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Association Between Neighborhood Deprivation and Heart Failure Among Patients With Diabetes Mellitus : A 10-Year Follow-Up Study in Sweden

Li, Xinjun LU ; Sundquist, Jan LU ; Forsberg, Per-Ola LU and Sundquist, Kristina LU (2019) In Journal of Cardiac Failure
Abstract

Background: Our aim was to study the potential effect of neighborhood deprivation on incident heart failure (HF) in patients with diabetes mellitus (DM). Methods: The study population included adults (n = 434,542) aged 30 years or older with DM followed from 2005 to 2015 in Sweden for incident HF. The association between neighborhood deprivation and the outcome was explored using Cox regression analysis, with hazard ratios (HRs) and 95% confidence intervals (95% CIs). All models were conducted in both men and women and adjusted for age, educational level, family income, employment status, region of residence, immigrant status, marital status, mobility, and comorbidities. DM patients living in neighborhoods with high or moderate levels... (More)

Background: Our aim was to study the potential effect of neighborhood deprivation on incident heart failure (HF) in patients with diabetes mellitus (DM). Methods: The study population included adults (n = 434,542) aged 30 years or older with DM followed from 2005 to 2015 in Sweden for incident HF. The association between neighborhood deprivation and the outcome was explored using Cox regression analysis, with hazard ratios (HRs) and 95% confidence intervals (95% CIs). All models were conducted in both men and women and adjusted for age, educational level, family income, employment status, region of residence, immigrant status, marital status, mobility, and comorbidities. DM patients living in neighborhoods with high or moderate levels of deprivation were compared with those living in neighborhoods with low deprivation scores (reference group). Results: There was an association between level of neighborhood deprivation and HF in DM patients. The HRs were 1.27, 95% CI 1.21–1.33, for men and 1.30, 95% CI 1.23–1.37, for women) among DM patients living in high deprivation neighborhoods compared with those from low deprivation neighborhoods. After adjustments for potential confounders, the higher HRs of HF remained significant: 1.11, 95% CI 1.06–1.16, in men and 1.15, 95% CI 1.09–1.21, in women living in high deprivation neighborhoods. Conclusions: Increased incidence rates of HF among DM patients living in deprived neighborhoods raise important clinical and public health concerns. These findings could serve as an aid to policy-makers when allocating resources in primary health-care settings as well as to clinicians who encounter patients in deprived neighborhoods.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
diabetes mellitus, Heart failure, neighborhood, Sweden
in
Journal of Cardiac Failure
publisher
Elsevier
external identifiers
  • scopus:85065925673
ISSN
1071-9164
DOI
10.1016/j.cardfail.2019.04.017
language
English
LU publication?
yes
id
02d9367e-9648-4fee-a5c4-63ee7b869c35
date added to LUP
2019-06-14 12:25:26
date last changed
2019-06-25 03:56:34
@article{02d9367e-9648-4fee-a5c4-63ee7b869c35,
  abstract     = {<p>Background: Our aim was to study the potential effect of neighborhood deprivation on incident heart failure (HF) in patients with diabetes mellitus (DM). Methods: The study population included adults (n = 434,542) aged 30 years or older with DM followed from 2005 to 2015 in Sweden for incident HF. The association between neighborhood deprivation and the outcome was explored using Cox regression analysis, with hazard ratios (HRs) and 95% confidence intervals (95% CIs). All models were conducted in both men and women and adjusted for age, educational level, family income, employment status, region of residence, immigrant status, marital status, mobility, and comorbidities. DM patients living in neighborhoods with high or moderate levels of deprivation were compared with those living in neighborhoods with low deprivation scores (reference group). Results: There was an association between level of neighborhood deprivation and HF in DM patients. The HRs were 1.27, 95% CI 1.21–1.33, for men and 1.30, 95% CI 1.23–1.37, for women) among DM patients living in high deprivation neighborhoods compared with those from low deprivation neighborhoods. After adjustments for potential confounders, the higher HRs of HF remained significant: 1.11, 95% CI 1.06–1.16, in men and 1.15, 95% CI 1.09–1.21, in women living in high deprivation neighborhoods. Conclusions: Increased incidence rates of HF among DM patients living in deprived neighborhoods raise important clinical and public health concerns. These findings could serve as an aid to policy-makers when allocating resources in primary health-care settings as well as to clinicians who encounter patients in deprived neighborhoods.</p>},
  author       = {Li, Xinjun and Sundquist, Jan and Forsberg, Per-Ola and Sundquist, Kristina},
  issn         = {1071-9164},
  keyword      = {diabetes mellitus,Heart failure,neighborhood,Sweden},
  language     = {eng},
  month        = {04},
  publisher    = {Elsevier},
  series       = {Journal of Cardiac Failure},
  title        = {Association Between Neighborhood Deprivation and Heart Failure Among Patients With Diabetes Mellitus : A 10-Year Follow-Up Study in Sweden},
  url          = {http://dx.doi.org/10.1016/j.cardfail.2019.04.017},
  year         = {2019},
}