Association between individual-level and community-level socio-economic status and blood pressure among Inuit in Greenland

Figures & data

Table I. Descriptive statistics of the participants, Inuit Health in Transition – Greenland Survey 2005–2010 (n=3,108)

Blood pressure
Systolic blood pressure in mmHg, mean (SD)		129.88 (20.13)
Diastolic blood pressure in mmHg, mean (SD)		78.93 (12.80)
Hypertension, % (n)		0.38 (1,171)
Individual characteristics
Sex (women), % (n)		0.56 (1,737)
Age, years, mean (SD)		44.43 (14.83)
Education High school education or less		0.60 (1,851)
Vocational training		0.29 (897)
Higher education		0.10 (307)
Language – Speaks Danish with difficulty or not at all, % (n)		0.43 (1,345)
Use of antihypertensive medication, % (n)		0.14 (434)
Family history of hypertension, % (n)		0.23 (716)
Tertiles of community-level equivalized average household income (SES)
by settlement type, % (n)^a	Towns; 0.76 (2,368)	Villages; 0.24 (740)
Lower SES (Mean DKK [95% CI]: 90,662 [80,813–100,509])^b	0 (0)	0.71 (525)
Middle SES (Mean DKK [95% CI]: 119,475 [113,162–125,788])^c	0.30 (713)	0.20 (150)
Higher SES (Mean DKK [95% CI]: 151,306 [132,377–170,234])^d	0.70 (1,655)	0.09 (65)

^aSample size of participants within community categorization; ^bMean (95% CI), in 2008 USD: $12,434 ($11,083–$13,784); ^cMean (95% CI), in 2008 USD: $16,385 ($15,519–$17,251); ^dMean (95% CI), in 2008 USD: $20,751 ($18,155–$23,346).

Fig. 1.  Unadjusted variation in the distribution of (a) SBP and (b) DBP among participants living in two communities categorized as A. a village with low SES and B. a town with average SES. Inuit Health in Transition – Greenland Survey 2005–2010.

Table II. Multilevel associations (coefficient [coeff] and 95% confidence intervals [95% CI]) between systolic and diastolic blood pressure and individual-level and community-level socio-economic status (SES), adjusting for individual characteristics, Inuit Health in Transition – Greenland Survey 2005–2010; n=2,992

	Systolic blood pressure		Diastolic blood pressure
	Model 1, Coeff (95% CI)	Model 2, Coeff (95% CI)	Model 1, Coeff (95% CI)	Model 2, Coeff (95% CI)
Education
High school or less	1.00	1.00	1.00	1.00
Vocational training	0.98 (−0.60, 2.56)	1.02 (−0.55, 2.59)	0.91 (−0.15, 1.98)^†	0.91 (−0.15, 1.98)^†
Higher education	−0.38 (−2.73, 1.97)	−0.11 (−2.45, 2.23)	−0.35 (−1.93, 1.23)	−0.31 (−1.90, 1.27)
Community characterization
Town, mid SES		1.00		1.00
Town, high SES		−3.61 (−5.24, −1.98)***		−4.11 (−6.71, −1.51)**
Village, low SES		−3.34 (−5.45, −1.22)**		−4.91 (−7.62, −2.19)***
Village, middle/high SES		−1.69 (−4.48, 1.11)		−3.97 (−7.09, −0.85)*
Sex
Men	1.00	1.00	1.00	1.00
Women	−8.77 (−10.06, −7.48)***	−8.77 (−10.06, −7.48)***	−3.59 (−4.46, −2.72)***	−3.59 (−4.46, −2.73)***
Age	−0.39 (−0.63, −0.15)**	−0.41 (−0.65, −0.17)**	0.91 (0.75, 1.07)***	0.91 (0.75, 1.07)***
Age squared	0.01 (0.01, 0.01)***	0.01 (0.01, 0.01)***	−0.01 (−0.01, −0.01)***	−0.01 (−0.01, −0.01)***
Speaks Danish
Yes	1.00	1.00	1.00	1.00
No	−1.49 (−2.98, 0.01)^†	−1.49 (−3.00, 0.02)^†	−1.80 (−2.82, −0.79)**	−1.74 (−2.77, −0.72)**
Use of antihypertensive medication
No	1.00	1.00	1.00	1.00
Yes	7.26 (5.23, 9.28)***	7.29 (5.27, 9.31)***	3.15 (1.79, 4.52)***	3.15 (1.79, 4.52)***
Family history of hypertension
No	1.00	1.00	1.00	1.00
Yes	2.77 (1.23, 4.32)***	2.66 (1.13, 4.20)**	1.49 (0.45, 2.54)**	1.49 (0.45, 2.53)**
Variance component	χ^2=11.48; p=0.003	χ^2=0.45; p=0.797	χ^2=82.51; p<0.001	χ^2=14.16; p=0.001

^† p<0.10; *p<0.05; **p<0.01; ***p<0.001.

Table III. Sex-stratified multilevel associations (coefficient [coeff] and 95% confidence intervals [95% CI]) between systolic and diastolic blood pressure and individual-level and community-level socio-economic status (SES), adjusting for individual characteristics, Inuit Health in Transition – Greenland Survey 2005–2010; n=1,294 for men, and n=1,648 for women

	Systolic blood pressure		Diastolic blood pressure
	Men, Coeff (95% CI)	Women, Coeff (95% CI)	Men, Coeff (95% CI)	Women, Coeff (95%CI)
Education
High school or less	1.00	1.00	1.00	1.00
Vocational training	1.91 (−0.47, 4.28)	0.98 (−1.13, 3.10)	1.49 (−0.16, 3.13)^†	0.14 (−1.26, 1.54)
Higher education	−0.05 (−3.72, 3.61)	0.59 (−2.43, 3.61)	−0.45 (−2.98, 2.08)	−0.27 (−2.27, 1.73)
Community characterization
Town, mid SES	1.00	1.00	1.00	1.00
Town, high SES	−5.49 (−9.19, −1.80)**	−2.28 (−4.65, 0.09)^†	−4.69 (−8.28, −1.10)*	−3.89 (−5.64, −2.14)***
Village, low SES	−6.08 (−10.27, −1.89)**	−1.19 (−4.12, 1.74)	−6.07 (−9.89, −2.26)**	−4.53 (−6.63, −2.44)***
Village, middle/high SES	−4.80 (−9.82, 0.22)^†	1.06 (−2.79, 4.92)	−5.40 (−9.77, −1.02)*	−3.16 (−5.84, −0.47)*
Age	−0.18 (−0.58, 0.21)	−0.54 (−0.84, −0.25)***	1.29 (1.02, 1.56)***	0.66 (0.47, 0.86)***
Age squared	0.01 (0.00, 0.01)*	0.01 (0.01, 0.02)***	−0.01 (−0.02, −0.01)***	−0.01 (−0.01, 0.00)***
Speaks Danish
Yes	1.00	1.00	1.00	1.00
No	−1.46 (−3.83, 0.91)	−1.15 (−3.10, 0.79)	−0.67 (−2.31, 0.96)	−2.40 (−3.69, −1.11)***
Use of antihypertensive medication
No	1.00	1.00	1.00	1.00
Yes	7.69 (4.23, 11.16)***	6.86 (4.42, 9.30)***	4.84 (2.45, 7.23)***	2.22 (0.60, 3.83)**
Family history of hypertension
No	1.00	1.00	1.00	1.00
Yes	2.58 (0.01, 5.16)*	2.86 (0.97, 4.75)**	0.94 (−0.84, 2.72)	1.82 (0.57, 3.07)**

^† p<0.10; *p<0.05; **p<0.01; ***p<0.001.