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Table 2 Summary of results adverse outcomes from NCDs

From: Socioeconomic inequalities in non-communicable diseases and their risk factors: an overview of systematic reviews

Author, year

Population

Outcome

Results

Risk of Bias

Cardiovascular diseases

   

Risk of mortality in heart failure:

Calvillo-King et al., 2012 [30]

Patients with heart failure in HIC

Mortality in heart failure after hospitalization (30 day)

Lower vs higher education: RR 1.05, 95 % CI: 0.98–1.12 (n = 1)

Unclear

Lower vs higher neighbourhood SES: RR 1.13, 95 % CI: 0.92–1.38 (n = 1)

Medicaid insurance vs other: OR 0.66, 95 % CI: 0.3–1.4 (4 studies, result from one)

≤ 25 miles to hospital vs > 25 miles to hospital: OR 0.95, 95 % CI: 0.92–0.98 (n = 1)

   

Early case fatalities of total strokes (%):

Feigin et al., 2009 [24]

Patients with stroke in HIC and LMIC

Early case fatality of stroke (21 day to 1 month)

HIC: non-significant reduction from 35.9 % (1970–79) to 19.8 % (2000–08)

Unclear

LMIC: non-significant reduction from 35.2 % (1980–89) to 26.6 % (2000–08)

Galobardes et al., 2006 [15]

General population mostly in HIC

Overall CVD, CHD, stroke, angina, other CVD subtypes mortality

19 out of 24 prospective studies found an association between low childhood SES and increased risk CVD mortality. In 5 out of 9 studies the association was stronger for stroke than CHD.

High

Galobardes et al., 2004 [10]

General population mostly in HIC

Overall CVD, CHD and stroke mortality

5 out of 9 studies found a higher risk of overall CVD mortality among those with low childhood SES, with results generally remaining statistically significant after adjustment for adult SES and/or adult CVD risk factors.

High

7 out of 10 studies found a higher risk of CHD mortality among those with low childhood SES, although adult SES attenuated the association in some studies. 4 out of 6 studies found a higher risk of stroke mortality among those with low childhood SES.

Pollitt et al., 2005 [17]

General population and patients with CVD and stroke from HIC

CVD, stroke mortality

11 out of 13 studies found a higher risk of CVD mortality among those with low childhood SES. Most associations remained statistically significant after adjustment for CVD risk factors and/or adult SES.

High

3 out of 3 studies showed a higher risk of stroke mortality among those with low childhood SES. Adjustment for adjustment for CVD risk factors and/or adult SES had minor impact on the effect.

5 out of 5 studies reported an association between cumulative life course exposure to low SES conditions and increased CVD mortality.

Sposato et al., 2012 [21]

Patients with stroke in HIC, MIC, and LIC

30-day case-fatality rates of stroke; intracerebral hemorrhages

Lower PPP-aGDP correlated with higher 30-day case-fatality rates of stroke (ρ = -0.713, p < 0.001) and a greater proportion of intracerebral hemorrhages (ρ = -0.689, p < 0.001).

Unclear

Lower PPP-aTHE correlated with higher 30-day case-fatality rates of stroke (ρ = -0.701, p < 0.001) and a greater proportion of intracerebral hemorrhages (ρ = -0.643, p < 0.001).

There was no correlation between unemployment and 30-day case-fatality rates of stroke (ρ = 0.204; p = 0.32) and proportion of intracerebral hemorrhages (ρ = -0.258, p = 0.184).

Cancers

   

Estimated survival of retinoblastoma:

Canturk et al., 2010 [31]

Patients with retinoblastoma in upper MIC, lower MIC, and LIC

Survival of retinoblastoma

Upper MIC: 79 % (range, 54–93 %);

Unclear

Lower MIC: 77 % (range, 60–92 %)

LIC: 40 % (range, 23–70 %) → p = 0.001

Galobardes et al., 2004 [10]

General population mostly in HIC

Overall cancer, lung cancer, other cancers mortality

4 out of 5 studies found no association between overall cancer mortality and childhood SES, and the effect was removed by adjustment for adult SES in the remaining study. 3 out of 3 studies found a higher risk of lung cancer mortality among those with low childhood SES, although the association was largely explained by adults SES in 2 studies. 1 study showed no association of childhood SES with other smoking-related cancers.

High

1 study found a higher risk of stomach cancer mortality among those with low childhood SES. 1 study found a higher risk of large-bowl and rectal cancer among those who had the poorest housing conditions during childhood.

There was no association between non-smoking related cancers (3 studies), prostate cancer (1 study) and malignant melanoma (1 study) mortality and childhood SES.

Gorey et al., 2009 [20]

Patients with breast cancer in the US and Canada

Breast cancer survival

Within Canada, there was no association between area-SES and breast cancer survival, a little survival disadvantage was only observed for lowest vs. highest income areas (pooled RR 0.94, 95 % CI 0.93–0.95).

High

Within the US, breast cancer survival was consistently associated with area-SES. Women with breast cancer from low and middle income areas had survival disadvantage compared to women from high income areas (pooled RR ranging from 0.73, 95 % CI 0.72–0.74 for low to 0.96, 95 % CI 0.94–0.98 for middle income area).

Slatore et al., 2010 [25]

Patients with lung cancer in the US

Lung cancer mortality

4 out of 4 studies showed a higher risk for lung cancer mortality for Medicaid insurance vs. other or private insurance. 2 studies showed mixed results on the association between Medicare vs Medicaid/Medicare and lung cancer mortality. 1 study showed a higher risk for lung cancer mortality for Medicare insurance and no insurance compared to private insurance. 2 studies showed no association between lung cancer mortality and insurance status. 1 study found mixed results for lung cancer mortality and different Medicare schemes.

Unclear

Chronic respiratory diseases

Galobardes et al., 2004 [10]

General population mostly in HIC

COPD mortality

1 study did not find an association between higher COPD mortality and overcrowding.

High

Gershon et al., 2012 [29]

Patients with COPD in HIC

COPD mortality

Individuals of the lowest SES consistently had significantly higher mortality from COPD than those of the highest, except for 1 study (out of 5) where income was not associated with COPD mortality.

Low

  1. SES Socioeconomic status, COPD Chronic obstructive pulmonary disease, RR Relative risk, OR Odds ratio, CI Confidence interval, p p-value, n number of studies, US United States, PPP-aGDP Per capita GDP adjusted for purchasing power parity, PPP-aTHE total health expenditures per capita at purchasing power parity, ρ Spearman rank correlation coefficient, y years, NCDs Non-communicable diseases, vs versus, LMIC Low and middle income countries, LIC Low income countries, MIC Middle income countries, HIC High income countries, PAD Peripheral artery disease, MI Myocardial infarction, CVD Cardiovascular diseases, CHD Coronary heart disease, IHD Ischaemic heart disease, IMT Intima-media thickness, AP Angina pectoris