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Cardiovascular risk factors—using repeated cross-sectional surveys to assess time trends in socioeconomic inequalities in neighbouring countries
  1. John Hughes1,
  2. Zubair Kabir2,
  3. Frank Kee1,
  4. Kathleen Bennett3
  1. 1UKCRC Centre of Excellence for Public Health, Queen's University, Belfast, UK
  2. 2Department of Epidemiology & Public Health University College Cork, Cork, Ireland
  3. 3Population Health Sciences Division, RCSI St Stephen's Green, Dublin, Ireland
  1. Correspondence to Dr Kathleen Bennett; kathleenebennett{at}


Objectives This study compares trends in socioeconomic inequalities related to key cardiovascular risk factors in neighbouring countries Northern Ireland (NI) and the Republic of Ireland (RoI).

Design Repeated cross-sectional studies.

Setting Population based.

Participants 3500–4000 in national surveys in NI and 5000–9000 in RoI, aged 20–69 years.

Measures Educational attainment was used as a socioeconomic indicator by which the magnitude and direction of trends in inequalities for smoking, diabetes, obesity and physical inactivity in NI and RoI were examined between 1997/1998 and 2007/2011. Gender-specific relative and absolute inequalities were calculated using the Relative Index of Inequality (RII) and Slope Index of Inequality (SII) for both countries.

Results In both countries, the prevalence of diabetes and obesity increased whereas levels of smoking and physical inactivity decreased over time. In NI relative inequalities increased for obesity (RII 1.1 in males and 2.1 in females in 2010/2011) and smoking (RII 4.5 in males and 4.2 in females in 2010/2011) for both genders and absolute inequalities increased for all risk factors in men and increased for diabetes and obesity in women. In RoI greater inequality was observed in women, particularly for smoking (RII 2.8 in 2007) and obesity (RII 8.2 in 2002) and in men for diabetes (RII 3.2 in 2002).

Conclusions Interventions to reduce inequalities in risk factors, particularly smoking, obesity and diabetes are encouraged across both countries.

  • health inequalities
  • Cardiovascular disease
  • Risk factors

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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  • Contributors JH, ZK, KB and FK were involved in the conception and design of this study. JH carried out the analysis. JH drafted the manuscript. JH, ZK, KB and FK provided advice on interpretation, and revised and edited the manuscript. All the authors read and approved the manuscript.

  • Funding The study was supported by the Centre of Excellence for Public Health NI.

  • Ethics approval The RoI health surveys, SLÁN 1998 and SLÁN 2002, were approved by the Faculty of Public Health Medicine, Royal College of Physicians of Ireland and SLÁN 2007 was approved by the Research Ethics Committee of the Royal College of Surgeons of Ireland.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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