Arrhythmias & electrophysiology
Association Between Life-Course Social and Racial Inequities and the Incidence of Major ECG Abnormalities in the ELSA-Brasil Cohort
Authors' conclusion
Life-course social and racial inequalities are associated with MEA incidence, particularly among women, underscoring the importance of social determinants in cardiovascular health.
Study context
- Population
- Participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) free of major ECG abnormalities (MEA) and cardiovascular disease at baseline (2008–2010)mean age 51 years (SD±8), 55.5% women
- Participants
- 11,761 participants
- Exposure
- Life-course socioeconomic position, intergenerational social mobility, race and racial discrimination and incidence of MEA, stratified by gender
- Outcome
- Cumulative incidence of MEA
- Follow-up
- 8 years
Main finding
As reported in the abstract
Cumulative incidence of MEA
15.8%
Observational data: associations, not effects.
Further findings
| Outcome | Estimate |
|---|---|
| Incidence of MEA by childhood socioeconomic position (women)Low childhood socioeconomic position vs High socioeconomic position · only among women | 48% higher (95% CI 1.17–1.87) |
| Incidence of MEA by race (women)Black women vs White women | 35% higher (95% CI 1.13–1.61) |
Incidence of MEA by adulthood socioeconomic position
- Low income and educational level associated with a higher incidence of MEA in both genders
- Occupational variables associated only among women
Incidence of MEA with social immobility at the base of the educational and socio-occupational hierarchy (women)
- Educational hierarchy: increase in MEA incidence
- 25% (95% CI, 1.04-1.49)
- Socio-occupational hierarchy: increase in MEA incidence
- 31% (95% CI, 1.08-1.61)
- Only among women
Incidence of MEA with lifetime exposure to racial discrimination
- Black women, hazard ratio
- 1.37 [95% CI, 1.04-1.82]
- Brown women, hazard ratio
- 1.70 [95% CI, 1.07-2.70]
- These associations were not observed among men
Original publication
Association Between Life-Course Social and Racial Inequities and the Incidence of Major ECG Abnormalities in the ELSA-Brasil Cohort. Circ Popul Health Outcomes. Published 16 February 2026. doi:10.
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