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A new study looking at risk of heart disease and stroke has found significant differences in the condition of the arteries of people living in deprived areas compared with people living in affluent areas.

Authors of the study, published in the British Medical Journal this week, analysed data from a group of 666 residents from the Greater Glasgow area who were recruited to the Psychosocial and Biological Determinants of Ill health (pSoBid) study and who were identified on the basis of how their area of residence ranked in the Scottish Index of Multiple Deprivation.

The principal investigator of the pSoBid study, Professor Chris Packard of the University of Glasgow, said, "Heart disease is just one of a number of chronic illnesses that occur more frequently in less affluent people. We need to understand why that is the case in order that the health divide can be tackled in a meaningful way. The pSoBid study indicates that we must look at factors other than the traditional ones. These might include processes of inflammation and our bodies’ response to environmental stress in early and later life. It is likely that the answers will be complex and require a new approach to improving the health of our poorer communities."

Dr Kevin Deans, lead author of the paper, added: "We already knew that the gap in life expectancy and health between those in most and least deprived areas is widening. While we must continue to encourage people to stop smoking, to eat healthily and to take enough exercise, we were interested in finding out why, despite current efforts, the health gap is increasing. In this study, we have found significant differences in the condition of the arteries when comparing people from most and least deprived areas. Only part of these differences was explained by what we call the ‘classical’ risk factors – for example, smoking, cholesterol or blood pressure. Surprisingly, none of the newer ‘emerging’ risk factors explained the differences seen either."

Dr Deans, a specialist registrar in Clinical Biochemistry and Metabolic Medicine at Glasgow Royal Infirmary, and his colleagues were able to look at the relationships between the psychological, social, behavioural and biological determinants of ill health within population groups in Glasgow that differed in socioeconomic status and their likelihood of developing chronic disease such as coronary heart disease.

Professor Carol Tannahill, the Director of the Glasgow Centre for Population Health which funded the study said the study reinforces the message that poverty is bad for health, and shows that people in our poorer communities have less healthy hearts.  She continued: "These findings suggest that there is scope to identify disease at an earlier stage, and that deprivation should be regarded as a risk factor for ill-health."

Commenting on the public health implications of his study, Dr Deans and colleagues write: “Our findings indicate the significance of area level deprivation as a predictor of future heart disease and stroke risk. Well known and recognised classical risk factors do not fully explain these differences between our two study groups suggesting that current public health messages directed at smoking, healthy eating and blood pressure, may not sufficiently tackle the gradient in cardiovascular disease we have identified”.

For more media information on pSoBid please contact:
Fiona McKie (Communications Manager, GCPH) on 0141 287 6959 or via email to Fiona.McKie@drs.glasgow.gov.uk

For University of Glasgow please contact Eleanor Cowie, Media Relations Manager on 0141 330 3683 or e.cowie@admin.gla.ac.uk

Notes to editors:

1. pSoBid (pronounced ‘so-bid’) is the study which sought to integrate established and new knowledge relating to the psychological, social, and biological determinants of health in Glasgow. The study aimed to relate the social conditions (area of residence, employment status, home ownership, educational attainment) of the population of Glasgow to their psychological profile (mental health and wellbeing, personality) and their biological status (physical health and wellbeing).

2. The pSoBid study has brought together expertise from social epidemiology, public health, biochemistry, psychology, neuroscience and genetics to build a better understanding of why living in poorer, more stressful circumstances results in higher levels of disease and ill-health. The study involved a sample of men and women aged 35 to 64 years; 342 participants from some of Greater Glasgow’s most affluent communities, and a further 324 participants from the poorest communities. 

3. The study will not provide definitive answers to questions about the causes of, or solutions to, the social gradient of ill health, but will certainly contribute new insights to these important issues.

4. pSoBid was established and funded by the Glasgow Centre for Population Health. The research fieldwork was carried out from December 2005 to May 2007.

5. The Glasgow Centre for Population Health (www.gcph.co.uk) is a partnership between NHS Greater Glasgow & Clyde, Glasgow City Council and the University of Glasgow, supported by the Scottish Government. The Centre seeks to generate insights and evidence, to create new solutions and provide leadership for action to improve health and tackle inequality.

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First published: 9 November 2009