A time-series analysis of the relation between unemployment rate and hospital admission for acute myocardial infarction and stroke in Brazil over more than a decade.
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2016-12
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Abstract
Background
The effect of socioeconomic stressors on the incidence of cardiovascular disease (CVD) is currently open to debate. Using time-series analysis, our study aimed to evaluate the relationship between unemployment rate and hospital admission for acute myocardial infarction (AMI) and stroke in Brazil over a recent 11-year span.Methods and results
Data on monthly hospital admissions for AMI and stroke from March 2002 to December 2013 were extracted from the Brazilian Public Health System Database. The monthly unemployment rate was obtained from the Brazilian Institute for Applied Economic Research, during the same period. The autoregressive integrated moving average (ARIMA) model was used to test the association of temporal series. Statistical significance was set at p<0.05. From March 2002 to December 2013, 778,263 admissions for AMI and 1,581,675 for stroke were recorded. During this time period, the unemployment rate decreased from 12.9% in 2002 to 4.3% in 2013, while admissions due to AMI and stroke increased. However, the adjusted ARIMA model showed a positive association between the unemployment rate and admissions for AMI but not for stroke (estimate coefficient=2.81±0.93; p=0.003 and estimate coefficient=2.40±4.34; p=0.58, respectively).Conclusions
From 2002 to 2013, hospital admissions for AMI and stroke increased, whereas the unemployment rate decreased. However, the adjusted ARIMA model showed a positive association between unemployment rate and admissions due to AMI but not for stroke. Further studies are warranted to validate our findings and to better explore the mechanisms by which socioeconomic stressors, such as unemployment, might impact on the incidence of CVD.Type
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Katz, Marcelo, Hayden B Bosworth, Renato D Lopes, Matthew E Dupre, Fernando Morita, Carolina Pereira, Fabio GM Franco, Rogerio R Prado, et al. (2016). A time-series analysis of the relation between unemployment rate and hospital admission for acute myocardial infarction and stroke in Brazil over more than a decade. International journal of cardiology, 224. pp. 33–36. 10.1016/j.ijcard.2016.08.309 Retrieved from https://hdl.handle.net/10161/29939.
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Scholars@Duke
Renato Delascio Lopes
Atrial Fibrillation
Antithrombotic Therapy in patients with Acute Coronary Syndromes
Elderly patients with Heart Disease
Biomarkers in Acute Coronary Syndromes and Atrial Fibrillation
Thrombosis and Anticoagulation and novel antithrombotic agents
Metabolomics in Cardiovascular Medicine
Matthew E. Dupre
Dr. Dupre is a Professor in the Department of Population Health Sciences and the Department of Sociology. He is also a Senior Fellow at the Center for Aging and Human Development. Dr. Dupre is a medical sociologist who specializes in research on aging and the life course, health disparities, and cardiovascular disease (CVD) outcomes in older adults. As an interdisciplinary researcher, he has focused on several lines of work: (i) race and socioeconomic disparities in trajectories of chronic disease and mortality, (ii) the role of social stressors in the onset and progression of CVD, (iii) the development of adaptive risk-assessment models, and (iv) the social determinants of healthy aging in China. A unifying thread in his program of research is the application of life course theory to clinical outcomes research, the integration of population- and patient-level data, and the use of innovative statistical methods to better understand how exposure to social factors shape inequalities in health and aging. Dr. Dupre is the Editor-in-Chief of the Encyclopedia of Gerontology and Population Aging (2021), co-editor of the book Disability Trends at Older Ages (in press), and has published in the leading journals of medicine, epidemiology, sociology, and public health. He has served as an advisor to the National Academy of Sciences' Committee on Population Aging and currently serves on the editorial boards for multiple journals.
Areas of Expertise:
Medical Sociology; Population Health; Social Epidemiology; Cardiovascular Disease; Aging; and Quantitative Methods
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