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Debbie A. Lawlor, PhD, MSc, MPH, MFPHM, MRCGP, MB, ChB, George Davey Smith, DSc, FFPHM, MD, MSc, MA, MB, BChr, Rita Patel, MSc BSc and Shah Ebrahim, DM, MSc, FFPHM, MRCP, MB, ChB

All of the authors are at the Department of Social Medicine, University of Bristol, Bristol, England.

Correspondence: Requests for reprints should be sent to Debbie A. Lawlor, Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, England (e-mail: d.a.lawlor{at}bristol.ac.uk).

Objectives. We sought to determine whether residential area deprivation, over and above the effect of life-course socioeconomic status or position (SEP), is associated with coronary heart disease.

Methods. We conducted a cross-sectional analysis of 4286 women aged 60 to 79 years from 457 British electoral wards.

Results. After adjustment for age and 10 indicators of individual life-course SEP, the odds of coronary heart disease was 27% greater among those living in wards with a deprivation score above the median compared with those living in a ward with a deprivation score equal to or below the median (odds ratio=1.27; 95% confidence interval=1.02, 1.57).

Conclusions. Adverse area-level socioeconomic characteristics, over and above individual life-course SEP, are associated with increased coronary heart disease.

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