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Research reports: Ingelise Andersen, Michael Gamborg, Merete Osler, Eva Prescott, and Finn Diderichsen Income as mediator of the effect of occupation on the risk of myocardial infarction: does the income measurement matter? J Epidemiol Community Health 2005; 59: 1080-1085 [Abstract] [Full text] [PDF]

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Response to Wenbin Lian

Ingelise Andersen, Michael Gamborg, Merete Osler, Eva Prescott, Finn Diderichsen   (20 December 2005)

Re: Income and the risk of MI

Wenbin Liang   (8 December 2005)

Response to Wenbin Lian 20 December 2005
Ingelise Andersen, research fellow Institute of Preventive Medicine, Copenhagen, DK, Michael Gamborg, Merete Osler, Eva Prescott, Finn Diderichsen Send letter to journal: Re: Response to Wenbin Lian ia{at}ipm.hosp.dk Ingelise Andersen, et al.	Dear Editor, Thank you for your interest in our article.[1] In our opinion, your comment, that gross household income (GHI) changed 24% of the increased risk among unskilled workers is not a real change, does not take into account that the two analyses are dependent. (Table 3, the two first columns). If the Hazard Ratio was 1.24 (the lower limit of the CI) instead of 1.55, this would also influence the Hazard Ratio in the model adjusted for GHI. We do, however, agree with you that the change is minor. But it has to be kept in mind, that there is no straightforward way to calculate CI for the mediated proportion. You might be right that an independent effect of GHI could show up if we stratified by occupational groups. Due to power problems this was, however, not possible. The effect of income from other adults in the family is accounted for as good as possible. But we agree with you that not only income but also the occupational social positions of other family members may also play an important role. References 1) Andersen I, Gamborg M, Osler M, Prescott E, Diderichsen F. Income as mediator of the effect of occupation on the risk of myocardial infarction: does the income measurement matter? J Epidemiol.Community Health 2005;59:1080-5.
Re: Income and the risk of MI 8 December 2005
Wenbin Liang, taking master of public health Curtin Universiy of Technology Send letter to journal: Re: Re: Income and the risk of MI wenbin.liang{at}postgrad.curtin.edu.au Wenbin Liang	Dear Editor, This study showed a nice way to estimate income level.[1] However in the paper it stated that there was a 24% changed of the increased risk among unskilled workers after “adjusting for GHI”—(1.55-1.42)/(1.55-1)=0.236, if estimating in the same way, the difference between the lower cut off point of the “CI”—1.24 and the point estimated hazard ratio—1.55 is (1.55-1.24)/0.55=56% of “the increased risk”,(data from table 3)[1] and therefore it may not be suitable to consider there is a “real” reduction in the “increased risk” as the reduction is much less than 56% of the “increased risk”. Nevertheless if there was an effect of income on the risk of MI that was unrelated to occupation, an effect of income might be observed within the same occupation category. Moreover when family income is also being investigated, it is possible that the occupation of other family members may play an important role on both of the family income and the life style of the family, and further “link” income with “MI” risk. Reference: 1. Andersen, I., et al., Income as mediator of the effect of occupation on the risk of myocardial infarction: does the income measurement matter? J Epidemiol Community Health, 2005. 59(12): p.1080-5.