This article is more than 5 years old. Information may no longer be current.

Variations in CHD mortality in England may be explained by population characteristics

Levene L. JAMA. 2010;304:2028-2034.

Issue: January 2011

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

The decrease in coronary heart disease mortality rates in England may be explained by population characteristics, including socioeconomic deprivation and registers of individuals with diabetes, new study data suggest.

“In England, with a universal access health system, CHD mortality rates have decreased by more than two-fifths in the last decade, but variations in rates between local populations persist,” the researchers wrote in their study.

To identify the cause for this discrepancy, the English researchers conducted a cross-sectional study of all primary care trusts in England (2008 registered population, n=54.3 million). The hierarchical regression model used featured a dependent variable of age-standardized CHD mortality rate and candidate explanatory variables of population characteristics (index of multiple deprivation, smoking, ethnicity and registers of individuals with diabetes) and service characteristics (level of provision of primary care services and detected hypertension, and pay for performance data). The main outcome measures were age-standardized CHD mortality rates in 2006, 2007 and 2008.

Researchers reported that the mean age-standardized CHD mortality rates per 100,000 European standard population were 97.9 (95% CI, 94.9-100.9) in 2006, 93.5 (95% CI, 90.4-96.5) in 2007 and 88.4 (95% CI, 85.7-91.1) in 2008. Four population characteristics that were significantly associated with CHD mortality in all 3 years included an index of multiple deprivation, smoking, white ethnicity and registers of individuals with diabetes, and the one service characteristic was levels of detected hypertension (2006 adjusted r²=0.66; 2007 adjusted r²=0.68; and 2008 adjusted r²=0.67).

“Although a decade-long national policy to lower CHD mortality succeeded, wide variation in rates persist. This wide variation in CHD mortality is explained predominantly by population factors,” the researchers concluded. “A population orientation may be important in promoting further declines in CHD mortality rates. The extent to which primary health care services can affect these population factors is not certain.”

Follow CardiologyToday.com on Twitter.