Cardiovascular Risk in the 1990s: Do Changes in Socioeconomic Effect Accompany Changes in Prevalence?

Diane S. Lauderdale, University of Chicago
Ronald A. Thisted, University of Chicago

We use two national probability survey examinations of the US population to compare prevalence of four key risk factors for cardiovascular disease at the beginning and end of the 1990s among middle-aged and older adults. We ask whether education and income differentials have changed for smoking, obesity, high cholesterol and high blood pressure during the 1990s with changing prevalence. We hypothesize that socioeconomic differentials will increase when risk factors decline. Because heart disease develops gradually, changes in the prevalence and socioeconomic determinants of these risk factors are likely to influence trends in mortality for decades. We are particularly interested in cholesterol because effective, expensive new medications were introduced in 1987. We find that smoking has declined, obesity has increased, high cholesterol has declined, and high blood pressure has declined for men. For smoking, obesity and cholesterol, we generally find the hypothesized inverse associations between changes in prevalence and socioeconomic effects.