Ethnicity and cardiovascular disease prevention

Baker, Jessica (2015) Ethnicity and cardiovascular disease prevention. PhD thesis, University of Glasgow.

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Abstract

Background: Public health interventions need to both improve health and reduce health inequalities, whilst using limited health care resources efficiently. Well-established ethnic differences in cardiovascular disease (CVD) raise the possibility that CVD prevention policies may not work equally well across ethnic groups. The aim of this thesis was to explore whether there are ethnic differences in the potential impact of two CVD prevention policy choices – the choice between mass and targeted screening for high cardiovascular risk, including the use of area deprivation measures to target screening, and the choice between population and high-risk approaches. Methods Cross-sectional data from the Health Survey for England 2003 and 2004 were used. Three sets of analyses were carried out – first, calculation of ethnic differences in the utility of area deprivation measures to identify individual socioeconomic deprivation; second, investigation of ethnic differences in the cost-effectiveness of mass and targeted screening for high cardiovascular risk; third, analysis of ethnic differences in the potential impact of population and high-risk approaches to CVD prevention. Results Area deprivation measures worked relatively effectively and efficiently at identifying individual socioeconomic deprivation in ethnic minority groups compared to the white group. In ethnic groups at high risk of CVD, cardiovascular risk screening programmes were a relatively cost-effective option, screening programmes targeted at deprived areas were particularly cost-effective, and population approaches were found to be an effective and equitable way of preventing CVD despite potential underestimation of their impact. Discussion This thesis found that ethnic minority groups in the UK are unlikely to be systematically disadvantaged by a range of CVD prevention policies that have been proposed, or implemented, for the general population. Additional CVD prevention policies, in particular those based on the population approach, should be implemented.

Item Type: Thesis (PhD)
Qualification Level: Doctoral
Additional Information: Please note the related publications listed at the start of the thesis, which relate to Chapters 4 and 5 respectively.
Keywords: public health, cardiovascular disease, disease prevention, ethnicity, health inequalities
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Colleges/Schools: College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
Funder's Name: UNSPECIFIED
Supervisor's Name: Pell, Professor Jill and Mitchell, Professor Richard
Date of Award: 2015
Depositing User: Dr. J Baker
Unique ID: glathesis:2015-6524
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 09 Jul 2015 12:23
Last Modified: 22 Jul 2015 15:36
URI: http://theses.gla.ac.uk/id/eprint/6524

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