Аннотация:Health policy now explicitly addresses the increasing inequalities arising within many countries.1 Although it is generally accepted that socioeconomic factors influence the overall rates of coronary heart disease events,2 studies of case fatality after admission to hospital for acute myocardial infarction show only modest socioeconomic gradients.3 By focusing on those who survive to reach hospital, however, such studies may underestimate the true influence of socioeconomic deprivation. Reports suggest that around 70-80% of deaths within 30 days of a myocardial infarction occur before admission to hospital, and this proportion increases with age.4 We therefore examined the effect of socioeconomic deprivation not only on case fatality in patients admitted with myocardial infarction but also on the risk of death before admission.
Data were obtained from the Scottish Morbidity Record and General Register Office on all Scottish residents for whom a first myocardial …