Continuing inequality: gender and social class influences on self perceived health after a heart attack

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Abstract
Study objective: To investigate the effect of social class and gender on self perceived health status for those recovering from an acute myocardial infarction. Design: A longitudinal survey design was used, collecting both qualitative and quantitative data. Quantitative data are reported in this article, obtained by questionnaire over the first year after the event. SF-36 and EQ-5D (EuroQol) were used to measure self perceived health status. Setting: Community based study in a city in the north of England. Participants: A consecutive sample of 229 people discharged from hospital after acute myocardial infarction. Main results: Overall gain in health status was found to be statistically significant over the year. Improvements were greatest in domains relating to role fulfilment and pursuit of normal and social activities. When analysed by gender, women showed poorer improvement than men, particularly in the domains relating to physical and social functioning. Analysed by social class, those without educational qualifications showed poorer improvement in pain experience and vitality. Access to a car was significant in avoiding physical limitations and promoting general health. Conclusions: Existing gradients between the health of women and men, and between the social classes, are maintained and probably exacerbated by the experience of acute illness, and health professionals need to be made aware of social groups who are at risk of poor rehabilitation.