Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Research article

Trends in absolute and relative educational inequalities in four modifiable ischaemic heart disease risk factors: repeated cross-sectional surveys from the Nord-Trøndelag Health Study (HUNT) 1984–2008

Authors: Linda Ernstsen, Bjørn Heine Strand, Sara Marie Nilsen, Geir Arild Espnes, Steinar Krokstad

Published in: BMC Public Health | Issue 1/2012

Login to get access

Abstract

Background

There has been an overall decrease in incident ischaemic heart disease (IHD), but the reduction in IHD risk factors has been greater among those with higher social position. Increased social inequalities in IHD mortality in Scandinavian countries is often referred to as the Scandinavian “public health puzzle”. The objective of this study was to examine trends in absolute and relative educational inequalities in four modifiable ischaemic heart disease risk factors (smoking, diabetes, hypertension and high total cholesterol) over the last three decades among Norwegian middle-aged women and men.

Methods

Population-based, cross-sectional data from The Nord-Trøndelag Health Study (HUNT): HUNT 1 (1984–1986), HUNT 2 (1995–1997) and HUNT 3 (2006–2008), women and men 40–59 years old. Educational inequalities were assessed using the Slope Index of Inequality (SII) and The Relative Index of Inequality (RII).

Results

Smoking prevalence increased for all education groups among women and decreased in men. Relative and absolute educational inequalities in smoking widened in both genders, with significantly higher absolute inequalities among women than men in the two last surveys. Diabetes prevalence increased in all groups. Relative inequalities in diabetes were stable, while absolute inequalities increased both among women (p = 0.05) and among men (p = 0.01). Hypertension prevalence decreased in all groups. Relative inequalities in hypertension widened over time in both genders. However, absolute inequalities in hypertension decreased among women (p = 0.05) and were stable among men (p = 0.33). For high total cholesterol relative and absolute inequalities remained stable in both genders.

Conclusion

Widening absolute educational inequalities in smoking and diabetes over the last three decades gives rise to concern. The mechanisms behind these results are less clear, and future studies are needed to assess if educational inequalities in secondary prevention of IHD are larger compared to educational inequalities in primary prevention of IHD. Continued monitoring of IHD risk factors at the population level is therefore warranted. The results emphasise the need for public health efforts to prevent future burdens of life-style-related diseases and to avoid further widening in socioeconomic inequalities in IHD mortality in Norway, especially among women.
Appendix
Available only for authorised users
Literature
1.
2.
Elstad J, Hofoss D, Dahl E: Contribution of specific causes of death to educational differences in mortality. Nor J Epidemiol. 2007, 17 (1): 37-42.
3.
Avendano M, Kunst AE, Huisman M, Lenthe FV, Bopp M, Regidor E, Glickman M, Costa G, Spadea T, Deboosere P, et al: Socioeconomic status and ischaemic heart disease mortality in 10 western European populations during the 1990s. Heart. 2006, 92 (4): 461-467.CrossRefPubMed
4.
Håheim LL, Holme I, Hjermann I, Leren P, Tonstad S: Trends in the incidence of acute myocardial infarction and stroke: a 21-year follow-up of the Oslo study. Scand Cardiovasc J. 2004, 38 (4): 216-221. 10.1080/14017430410014910.CrossRefPubMed
5.
Pajunen P, Pääkkönen R, Juolevi A, Hämäläinen H, Keskimäki I, Laatikainen T, Moltchanov V, Niemi M, Rintanen H, Salomaa V: Trends in fatal and non-fatal coronary heart disease events in Finland during 1991–2001. Scand Cardiovasc J. 2004, 38 (6): 340-344. 10.1080/14017430410010996.CrossRefPubMed
6.
Ford ES, Ajani UA, Croft JB, Critchley JA, Labarthe DR, Kottke TE, Giles WH, Capewell S: Explaining the Decrease in U.S. Deaths from Coronary Disease, 1980–2000. N Engl J Med. 2007, 356 (23): 2388-2398. 10.1056/NEJMsa053935.CrossRefPubMed
7.
Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J, et al: Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case–control study. Lancet. 2004, 364 (9438): 937-952. 10.1016/S0140-6736(04)17018-9.CrossRefPubMed
8.
Dale AC, Nilsen TI, Vatten L, Midthjell K, Wiseth R: Diabetes mellitus and risk of fatal ischaemic heart disease by gender: 18 years follow-up of 74 914 individuals in the HUNT 1 Study. Eur Heart J. 2007, 28 (23): 2924-2929. 10.1093/eurheartj/ehm447.CrossRefPubMed
9.
Barrett-Connor EL, Cohn BA, Wingard DL, Edelstein SL: Why is diabetes mellitus a stronger risk factor for fatal ischemic heart disease in women than in men? The Rancho Bernardo Study. JAMA. 1991, 265 (5): 627-631. 10.1001/jama.1991.03460050081025. erratum appears in JAMA 1991 Jun 26;265(24):3249]CrossRefPubMed
10.
Espelt A, Borrell C, Roskam A, Rodríguez-Sanz M, Stirbu I, Dalmau-Bueno A, Regidor E, Bopp M, Martikainen P, Leinsalu M, et al: Socioeconomic inequalities in diabetes mellitus across Europe at the beginning of the 21st century. Diabetologia. 2008, 51 (11): 1971-1979. 10.1007/s00125-008-1146-1.CrossRefPubMed
11.
Miura K, Giskes K, Turrell G: Socioeconomic differences in takeaway food consumption and their contribution to inequalities in dietary intakes. J Epidemiol Community Health. 2009, 63 (10): 820-826. 10.1136/jech.2008.086504.CrossRefPubMed
12.
Giskes K, Avendano M, Brug J, Kunst A: A systematic review of studies on socioeconomic inequalities in dietary intakes associated with weight gain and overweight/obesity conducted among European adults. Obes Rev. 2010, 11 (6): 413-429.CrossRefPubMed
13.
Huxley RR, Woodward M: Cigarette smoking as a risk factor for coronary heart disease in women compared with men: a systematic review and meta-analysis of prospective cohort studies. Lancet. 2011, 378 (9799): 1297-1305. 10.1016/S0140-6736(11)60781-2.CrossRefPubMed
14.
Mannsverk J, Wilsgaard T, Njølstad I, Hopstock LA, Løchen M-L, Mathiesen EB, Thelle DS, Rasmussen K, Bønaa KH: Age and gender differences in incidence and case fatality trends for myocardial infarction: a 30-year follow-up. The Tromsø Study. Eur J Cardiovasc Prev Rehabil. 2011, 10.1177/1741826711421081.
15.
Dahl E, Hofoss D, Elstad JI: Educational inequalities in avoidable deaths in Norway: A population based study. Heal Sociol Rev. 2007, 16 (2): 146-159. 10.5172/hesr.2007.16.2.146.CrossRef
16.
Huisman M, Kunst AE, Mackenbach JP: Educational inequalities in smoking among men and women aged 16 years and older in 11 European countries. Tob Control. 2005, 14 (2): 106-113. 10.1136/tc.2004.008573.CrossRefPubMedPubMedCentral
17.
Stringhini S, Sabia S, Shipley M, Brunner E, Nabi H, Kivimaki M, Singh-Manoux A: Association of Socioeconomic Position With Health Behaviors and Mortality. JAMA. 2010, 303 (12): 1159-1166. 10.1001/jama.2010.297.CrossRefPubMedPubMedCentral
18.
Strand BH, Groholt E-K, Steingrimsdottir OA, Blakely T, Graff-Iversen S, Naess O: Educational inequalities in mortality over four decades in Norway: prospective study of middle aged men and women followed for cause specific mortality, 1960–2000. BMJ. 2010, 340 (2): c654-10.1136/bmj.c654.CrossRefPubMedPubMedCentral
19.
Bambra C: Health inequalities and welfare state regimes: theoretical insights on a public health ‘puzzle’. J Epidemiol Community Health. 2011, 65 (9): 740-745. 10.1136/jech.2011.136333.CrossRefPubMed
20.
21.
Kunst AE, Mackenbach JP: Measuring socioeconomic inequalities in health. 2000, World Health Organization Regional Office for Europe, Copenhagen
22.
Holmen J, Midthjell K, Bjartveit K, Hjort PF, Lund-Larsen PG, Moum T, et al: The Nord-Trøndelag Helath Survey 1984–86. Purpose, background and methods. Participation, non-participation and frequency distributions. 1990, Statens institutt for folkehelse, Senter for samfunnsmedisinsk forskning, Verdal, Norway, Report No.: 4/1990
23.
Holmen J, Midthjell K, Øystein Krüger Ø, Langhammer A, Holmen TL, Bratberg G, Vatten L, Lund-Larsen PG: The Nord-Trøndelag Health Study 1995–97 (HUNT 2): Objectives, contents, methods and participation. Nor J Epidemiol. 2003, 13 (1): 19-32.
24.
Krieger N, Williams DR, Moss NE: Measuring social class in US Public Health Research:Concepts, Methodologies, and Guidelines. Annu Rev Public Health. 1997, 18 (1): 341-378. 10.1146/annurev.publhealth.18.1.341.CrossRefPubMed
25.
Rosengren A, Subramanian SV, Islam S, Chow CK, Avezum A, Kazmi K, Sliwa K, Zubaid M, Rangarajan S, Yusuf S: Education and risk for acute myocardial infarction in 52 high, middle and low-income countries: INTERHEART case–control study. Heart. 2009, 95 (24): 2014-2022. 10.1136/hrt.2009.182436.CrossRefPubMed
26.
Marmot M, Bartely M: Social class and coronary heart disease. Stress and the heart: Psychosocial pathways to coronary heart disease. Edited by: Stansfeld S, Marmot M. 2002, BMJ Books, London, 5-19.
27.
Organisation for Economic Co-Operation and Development. OECD Handbook for Internationally Comparative Education Statistics: Concepts, Standards, Definitions and Classifications. 2004
28.
Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R, Dallongeville J, De Backer G, Ebrahim S, Gjelsvik B, et al: European guidelines on cardiovascular disease prevention in clinical practice: executive summary: Fourth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (Constituted by representatives of nine societies and by invited experts). Eur Heart J. 2007, 28 (19): 2375-2414.CrossRefPubMed
29.
Mackenbach JP, Kunst AE: Measuring the magnitude of socio-economic inequalities in health: An overview of available measures illustrated with two examples from Europe. Soc Sci Med. 1997, 44 (6): 757-771. 10.1016/S0277-9536(96)00073-1.CrossRefPubMed
30.
Barros A, Hirakata V: Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol. 2003, 3 (1): 21-10.1186/1471-2288-3-21.CrossRefPubMedPubMedCentral
31.
Khang YH, Yun SC, Lynch JW: Monitoring trends in socioeconomic health inequalities: it matters how you measure. BMC Publ Health. 2008, 8: 66-10.1186/1471-2458-8-66.CrossRef
32.
Spiegelman D, Hertzmark E: Easy SAS Calculations for Risk or Prevalence Ratios and Differences. Am J Epidemiol. 2005, 162 (3): 199-200. 10.1093/aje/kwi188.CrossRefPubMed
33.
Osler M, Gerdes LU, Davidsen M, Brønnum-Hansen H, Madsen M, Jørgensen T, Schroll M: Socioeconomic status and trends in risk factors for cardiovascular diseases in the Danish MONICA population, 1982–1992. J Epidemiol Community Health. 2000, 54 (2): 108-113. 10.1136/jech.54.2.108.CrossRefPubMedPubMedCentral
34.
Bennett S: Cardiovascular risk factors in Australia: trends in socioeconomic inequalities. J Epidemiol Community Health. 1995, 49 (4): 363-372. 10.1136/jech.49.4.363.CrossRefPubMedPubMedCentral
35.
Kanjilal S, Gregg EW, Cheng YJ, Zhang P, Nelson DE, Mensah G, Beckles GLA: Socioeconomic Status and Trends in Disparities in 4 Major Risk Factors for Cardiovascular Disease Among US Adults, 1971–2002. Arch Intern Med. 2006, 166 (21): 2348-2355. 10.1001/archinte.166.21.2348.CrossRefPubMed
36.
Hotchkiss JW, Davies C, Gray L, Bromley C, Capewell S, Leyland AH: Trends in adult cardiovascular disease risk factors and their socio-economic patterning in the Scottish population 1995–2008: cross-sectional surveys. BMJ Open. 2011, 10.1136/bmjopen-2011-000176.
37.
Smith P, Frank J, Mustard C: Trends in educational inequalities in smoking and physical activity in Canada: 1974–2005. J Epidemiol Community Health. 2009, 63 (4): 317-323. 10.1136/jech.2008.078204.CrossRefPubMed
38.
Peltonen HSLA: Secular trends in social patterning of cardiovascular risk factor levels in Sweden. The Northern Sweden MONICA Study 19861994. J Intern Med. 1998, 244 (1): 1-9.CrossRefPubMed
39.
Evans A, Tolonen H, Hense H-W, Ferrario M, Sans S, Kuulasmaa K: Trends in coronary risk factors in the WHO MONICA Project. Int J Epidemiol. 2001, 30 (1): 35-40. 10.1093/ije/30.1.35.CrossRef
40.
Cavelaars AEJM, Kunst AE, Geurts JJM, Crialesi R, Grotvedt L, Helmert U, Lahelma E, Lundberg O, Matheson J, Mielck A, et al: Educational differences in smoking: international comparison. BMJ. 2000, 320 (7242): 1102-1107. 10.1136/bmj.320.7242.1102.CrossRefPubMedPubMedCentral
41.
Giskes K, Kunst AE, Benach J, Borrell C, Costa G, Dahl E, Dalstra JAA, Federico B, Helmert U, Judge K, et al: Trends in smoking behaviour between 1985 and 2000 in nine European countries by education. J Epidemiol Community Health. 2005, 59 (5): 395-401. 10.1136/jech.2004.025684.CrossRefPubMedPubMedCentral
42.
Lund KE, Lund M: Smoking and inequality in Norway 1998–2000. Tidsskr Nor Lægeforen. 2005, in Norwegian, english abstract: 560-563. in Norwegian, english abstract
43.
Lopez AD, Collishaw NE, Piha T: A descriptive model of the cigarette epidemic in developed countries. Tob Control. 1994, 3: 242-247. 10.1136/tc.3.3.242.CrossRefPubMedCentral
44.
Laaksonen M, Práttalä R, Karisto A: Patterns of unhealthy behaviour in Finland. Eur J Public Health. 2001, 11 (3): 294-300. 10.1093/eurpub/11.3.294.CrossRefPubMed
45.
Imkampe AK, Gulliford MC: Increasing socio-economic inequality in type 2 diabetes prevalence—Repeated cross-sectional surveys in England 1994–2006. Eur J Public Health. 2011, 21 (4): 484-490. 10.1093/eurpub/ckq106.CrossRefPubMed
46.
Redondo A, Benach J, Subirana I, Martinez JM, Muñoz MA, Masiá R, Ramos R, Sala J, Marrugat J, Elosua R: Trends in the Prevalence, Awareness, Treatment, and Control of Cardiovascular Risk Factors across Educational Level in the 1995–2005 Period. Ann Epidemiol. 2011, 21 (8): 555-563. 10.1016/j.annepidem.2011.02.008.CrossRefPubMed
47.
Ricci-Cabello I, Ruiz-Pérez I, De Labry-Lima AO, Márquez-Calderón S: Do social inequalities exist in terms of the prevention, diagnosis, treatment, control and monitoring of diabetes? A systematic review. Health Soc Care Community. 2010, 18 (6): 572-587. 10.1111/j.1365-2524.2010.00960.x.CrossRefPubMed
48.
Eriksson M, Holmgren L, Janlert U, Jansson JH, Lundblad D, Stegmayr B, Söderberg S, Eliasson M: Large improvements in major cardiovascular risk factors in the population of northern Sweden: the MONICA study 1986–2009. J Intern Med. 2011, 269 (2): 219-231. 10.1111/j.1365-2796.2010.02312.x.CrossRefPubMed
49.
Pekkanen J, Uutela A, Valkonen T, Vartiainen E, Tuomilehto J, Puska P: Coronary risk factor levels: differences between educational groups in 1972–87 in eastern Finland. J Epidemiol Community Health. 1995, 49 (2): 144-149. 10.1136/jech.49.2.144.CrossRefPubMedPubMedCentral
50.
Grotto I, Huerta M, Sharabi Y: Hypertension and socioeconomic status. Curr Opin Cardiol. 2008, 23 (4): 335-339. 10.1097/HCO.0b013e3283021c70.CrossRefPubMed
51.
Shah S, Cook DG: Inequalities in the treatment and control of hypertension: age, social isolation and lifestyle are more important than economic circumstances. J Hypertens. 2001, 19 (7): 1333-1340. 10.1097/00004872-200107000-00020.CrossRefPubMed
52.
Munoz M-A, Rohlfs I, Masuet S, Rebato C, Cabañero M, Marrugat J, Group ftIS: Analysis of inequalities in secondary prevention of coronary heart disease in a universal coverage health care system. Eur J Public Health. 2006, 16 (4): 361-367. 10.1093/eurpub/cki202.CrossRefPubMed
53.
He FJ, MacGregor GA: Reducing Population Salt Intake Worldwide: From Evidence to Implementation. Prog Cardiovasc Dis. 2010, 52 (5): 363-382. 10.1016/j.pcad.2009.12.006.CrossRefPubMed
54.
Pedersen JI, Tverdal A, Kirkhus B: Diet and the rise and fall of cardiovascular disease mortality in Norway. Tidsskr Nor Lægeforen. 2004, 124 (11): 1532-1536. in Norwegian, abstract in EnglishPubMed
55.
Strand B, Tverdal A: Trends in educational inequalities in cardiovascular risk factors: A longitudinal study among 48,000 middle-aged Norwegian men and women. Eur J Epidemiol. 2006, 21 (10): 731-739. 10.1007/s10654-006-9046-5.CrossRefPubMed
56.
Loucks E, Abrahamowicz M, Xiao Y, Lynch J: Associations of education with 30 year life course blood pressure trajectories: Framingham Offspring Study. BMC Publ Health. 2011, 11 (1): 139-10.1186/1471-2458-11-139.CrossRef
57.
Danaei G, Finucane MM, Lin JK, Singh GM, Paciorek CJ, Cowan MJ, Farzadfar F, Stevens GA, Lim SS, Riley LM, et al: National, regional, and global trends in systolic blood pressure since 1980: systematic analysis of health examination surveys and epidemiological studies with 786 country-years and 5·4 million participants. Lancet. 2011, 377 (9765): 568-577. 10.1016/S0140-6736(10)62036-3.CrossRefPubMed
58.
Jansson J-H, Aring KAN, Boman K, Messner T, Ouml RN: Trends in blood pressure, lipids, lipoproteins and glucose metabolism in the Northern Sweden MONICA project 1986–99. Scand J Public Health. 2003, 31 (5 supp 61): 43-50.CrossRef
59.
Eliasson M, Janlert U, Jansson JH, Stegmayr B: Time trends in population cholesterol levels 1986–2004: influence of lipid-lowering drugs, obesity, smoking and educational level. The northern Sweden MONICA study. J Intern Med. 2006, 260 (6): 551-559. 10.1111/j.1365-2796.2006.01730.x.CrossRefPubMed
60.
Bartholomeeusen S, Vandenbroucke J, Truyers C, Buntinx F: Trends in total cholesterol screening and in prescribing lipid-lowering drugs in general practice in the period 1994–2003. BMC Fam Pract. 2008, 9 (1): 39-10.1186/1471-2296-9-39.CrossRefPubMedPubMedCentral
61.
Selmer R, Sakshaug S, Skurtveit S, Furu K, Tverdal A: Statin treatment in a cohort of 20 212 men and women in Norway according to cardiovascular risk factors and level of education. Br J Clin Pharmacol. 2009, 67 (3): 355-362. 10.1111/j.1365-2125.2008.03360.x.CrossRefPubMedPubMedCentral
62.
Farzadfar F, Finucane MM, Danaei G, Pelizzari PM, Cowan MJ, Paciorek CJ, Singh GM, Lin JK, Stevens GA, Riley LM, et al: National, regional, and global trends in serum total cholesterol since 1980: systematic analysis of health examination surveys and epidemiological studies with 321 country-years and 3·0 million participants. Lancet. 2011, 377 (9765): 578-586. 10.1016/S0140-6736(10)62038-7.CrossRefPubMed
63.
Nakamura K, Barzi F, Huxley R, Lam T-H, Suh I, Woo J, Kim HC, Feigin VL, Gu D, Woodward M: Does cigarette smoking exacerbate the effect of total cholesterol and high-density lipoprotein cholesterol on the risk of cardiovascular diseases?. Heart. 2009, 95 (11): 909-916. 10.1136/hrt.2008.147066.CrossRefPubMed
64.
Galea S, Tracy M: Participation Rates in Epidemiologic Studies. Ann Epidemiol. 2007, 17 (9): 643-653. 10.1016/j.annepidem.2007.03.013.CrossRefPubMed
65.
Torvik F, Rognmo K, Tambs K: Alcohol use and mental distress as predictors of non-response in a general population health survey: the HUNT study. Soc Psychiatry Psychiatr Epidemiol. 2011, 1–12: 10.1007/s00127-011-0387-3.
66.
Thoen H, Krokstad S: The Nord-Trøndelag Health Study [in Norwegian]. Public Health development- The HUNT Study, Norway HUNT 1 (1984–86) - HUNT 2 (1995–97) - HUNT 3 (2006–08). Edited by: Krokstad S, Knutsen MS. 2011, HUNT Research Center, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Levanger, Trondheim, Norway, 9-16.
67.
Goldberg M, Chastang JF, Leclerc A, Zins M, Bonenfant S, Bugel I, Kaniewski N, Schmaus A, Niedhammer I, Piciotti M, et al: Socioeconomic, Demographic, Occupational, and Health Factors Associated with Participation in a Long-term Epidemiologic Survey: A Prospective Study of the French GAZEL Cohort and Its Target Population. Am J Epidemiol. 2001, 154 (4): 373-384. 10.1093/aje/154.4.373.CrossRefPubMed
68.
Tolonen H, Dobson A, Kulathinal S: Effect on Trend Estimates of the Difference between Survey Respondents and Non-respondents: Results from 27 Populations in the WHO MONICA Project. Eur J Epidemiol. 2005, 20 (11): 887-898. 10.1007/s10654-005-2672-5.CrossRefPubMed
69.
Tunstall-Pedoe H, Kuulasmaa K, Mähönen M, Tolonen H, Ruokokoski E: Contribution of trends in survival and coronar y-event rates to changes in coronary heart disease mortality: 10-year results from 37 WHO MONICA Project populations. Lancet. 1999, 353 (9164): 1547-1557. 10.1016/S0140-6736(99)04021-0.CrossRefPubMed
70.
Rehkopf DH, Dow WH, Rosero-Bixby L: Differences in the association of cardiovascular risk factors with education: a comparison of Costa Rica (CRELES) and the USA (NHANES). J Epidemiol Community Health. 2010, 64 (9): 821-828. 10.1136/jech.2009.086926.CrossRefPubMed
71.
72.
Okura Y, Urban LH, Mahoney DW, Jacobsen SJ, Rodeheffer RJ: Agreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure. J Clin Epidemiol. 2004, 57 (10): 1096-1103. 10.1016/j.jclinepi.2004.04.005.CrossRefPubMed
73.
Patrick DL, Cheadle A, Thompson DC, Diehr P, Koepsell T, Kinne S: The Validity of Self-Reported Smoking: A Review and Meta-Analysis. Am J Public Health. 1994, 84 (7): 1086-1093. 10.2105/AJPH.84.7.1086.CrossRefPubMedPubMedCentral
Metadata
Title
Trends in absolute and relative educational inequalities in four modifiable ischaemic heart disease risk factors: repeated cross-sectional surveys from the Nord-Trøndelag Health Study (HUNT) 1984–2008
Authors
Linda Ernstsen
Bjørn Heine Strand
Sara Marie Nilsen
Geir Arild Espnes
Steinar Krokstad
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-266

Other articles of this Issue 1/2012

BMC Public Health 1/2012 Go to the issue

Research article

Combined influence of media use on subjective health in elementary school children in Japan: a population-based study

Research article

The effect of exercise on prescription on physical activity and wellbeing in a multi-ethnic female population: A controlled trial

Research article

A prospective study of complications from comprehensive abortion care services in Nepal

Research article

Leading during change: the effects of leader behavior on sickness absence in a Norwegian health trust

Research article

Wearing face masks in public during the influenza season may reflect other positive hygiene practices in Japan

Research article

Incidence and correlates of receiving cigarettes as gifts and selecting preferred brand because it was gifted: Findings from the ITC China Survey