ArticleBMC public health2025
Cardiovascular disease risk associated with housing disadvantages among middle-aged and older populations in China: a cohort study.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEvidence for associations of housing disadvantages with cardiovascular disease (CVD) is scarce. This study aimed to assess the association of housing disadvantages with CVD among middle-aged and older populations in China.
methodsWe conducted analyses by data from China Health and Retirement Longitudinal Study, 2011-2018. CVD events were ascertained by self-reported data. A total of 9,843 individuals were included in stroke sub-cohort, and 8,752 individuals were included in heart disease sub-cohort. Cox regression was used to estimate hazard ratio (95% confidence interval (CI)) of housing disadvantages with CVD. Population attributable fractions were calculated through Levin's formula and Monte-Carlo simulation to estimate the CVD incidence associated with housing disadvantages in China.
resultsWe found that using crops (HR = 1.35; 95% CI: 1.08-1.68) and coal fuel (HR: 1.71, 95%CI: 1.40-2.10) as heating energy sources were positively associated with heart disease risk compared to clean fuels. Unsafe sanitation was found to be associated with 43% (HR: 1.43, 95%CI: 1.23-1.66) higher heart disease risk and 30% (HR: 1.30, 95%CI: 1.06-1.60) higher stroke risk, and unsafe water source was positively associated with stroke risk (HR: 1.30, 95%CI: 1.08-1.56). Geographical disparities in CVD cases associated with housing disadvantages at a provincial level were found. Annually 1,380,000 cases (15.1%), 718,000 cases (7.9%), and 1,471,000 cases (16.1%) of heart diseases were associated with coal heating energy use, crop heating energy use, and unsafe sanitation, separately. 360,000 cases (12.1%) and 189,000 cases (6.4%) of strokes were associated with unsafe sanitation and unsafe water sources. Regions with lower socio-economic status had higher PAF.
conclusionsThese findings suggested that housing disadvantages were associated with CVD risk in China and highlighted geographical inequality in cardiovascular diseases associated with housing disadvantages.
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