Juliane Tetzlaff , Hannover Medical School
Siegfried Geyer, Hannover Medical School
Fabian Tetzlaff, Robert Koch-Institute
Stefanie Sperlich, Hannover Medical School
Jelena Epping, Hannover Medical School
Background: Although incidence and mortality rates of myocardial infarction (MI) have decreased substantially over the last decades, little is known on whether all socioeconomic groups benefitted equally from these improvements. The study investigates the development of MI incidence and mortality risks over time. Special emphasis is laid on the question whether trends in MI-free life years and life years after MI differ between income groups. Methods: The analyses are based on claims data of a German statutory health insurance covering the periods 2006-2008 and 2015-2017. Income inequalities in MI incidence and mortality were estimated using multistate survival analyses. Trends in life years were calculated separately for two income groups (= 60% and > 60% of the German average income) using multistate life table analyses. Results: MI incidence and mortality risks decreased among all income groups, but they were more pronounced in the higher income group. Significant increases in the number of life years free of MI could only be found among men and women in the higher income group. While the number of life years after MI increased among men of both income groups, no changes were observed in women. Discussion: Not all groups benefitted equally from decreasing MI incidence and mortality risks. Trends in incidence and in mortality differ between income groups as well as between sexes. Especially men with low incomes are disadvantaged as no healthy years could be gained, thus leading to a clear expansion of lifetime in morbidity.
Presented in Session 80. Healthy Life Expectancies I