Neighbourhood deprivation and hospitalization for atrial fibrillation in Sweden

Europace. 2013 Aug;15(8):1119-27. doi: 10.1093/europace/eut019. Epub 2013 Feb 27.


Aims: Several cardiovascular disorders (CVDs) are strongly associated with socioeconomic disparities and neighbourhood deprivation. However, no study has determined whether neighbourhood deprivation is associated with atrial fibrillation (AF). We aimed to determine whether there is an association between neighbourhood deprivation and hospitalization for AF.

Methods and results: The entire Swedish population aged 25-74 years was followed from 1 January 2000 until hospitalization for AF, death, emigration, or the end of the study period (31 December 2008). Data were analysed by multilevel logistic regression, with individual-level characteristics (age, marital status, family income, educational attainment, migration status, urban/rural status, mobility, and comorbidity) at the first level and level of neighbourhood deprivation at the second level. Neighbourhood deprivation was significantly associated with AF hospitalization rate in women [odds ratio (OR) = 1.40, 95% confidence interval (CI) 1.35-1.47], but not men (OR = 1.01, 95% CI 0.97-1.04). The odds of AF in women living in the most deprived neighbourhoods remained significant after adjustment for age and individual-level socioeconomic characteristics (OR = 1.12, 95% 1.08-1.16). However, in the full model, which took account of age, individual-level socioeconomic characteristics, and comorbidities (chronic lower respiratory diseases, OR = 1.30; type 2 diabetes, OR = 1.32; alcoholism and alcohol-related liver disease, OR = 1.57; hypertension, OR = 2.84; obesity, OR = 1.80; heart failure, OR = 7.40; coronary heart disease, OR = 1.81; and hyperthyroidism, OR = 6.79), the odds of AF did not remain significant in women in the most deprived neighbourhoods (OR = 1.03, 95% CI 0.99-1.07).

Conclusion: Neighbourhood deprivation and socioeconomic disparities are not independently associated with hospitalized AF in contrast to many other CVDs.

Keywords: Atrial fibrillation; Neighbourhood deprivation; Risk factors; Socioeconomic factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Atrial Fibrillation / mortality*
  • Atrial Fibrillation / therapy*
  • Emigrants and Immigrants / statistics & numerical data*
  • Employment
  • Female
  • Health Status Disparities*
  • Healthcare Disparities / statistics & numerical data*
  • Hospital Mortality
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Residence Characteristics / statistics & numerical data*
  • Risk Factors
  • Sex Distribution
  • Social Class
  • Socioeconomic Factors
  • Survival Rate
  • Sweden / epidemiology