{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T07:53:25Z","timestamp":1777708405898,"version":"3.51.4"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,1,4]],"date-time":"2026-01-04T00:00:00Z","timestamp":1767484800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100020623","name":"Yonsei University College of Nursing","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020623","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Income influences individuals\u2019 engagement in health behaviours, which may mediate the relationship between income and cardiovascular event incidence. However, research on the association between cardiovascular event and cumulative low-income status remains limited, as most previous studies have assessed income at a single time point. This study aimed to investigate the association between cumulative low-income status and cardiovascular event incidence and to explore the mediating role of engagement in health behaviour.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In this retrospective cohort study, we analysed national representative data from the Korea Health Panel Survey (2008\u20132018), including 9284 Korean adults. Cumulative low-income status was defined based on total number of years classified as low-income status during the 3 year baseline. Cardiovascular event incidence was defined as the first diagnosis of myocardial infarction, stroke, or cardiovascular disease-related death. Engagement in health behaviour was measured through smoking, alcohol consumption, and physical activity. After adjusting for covariates, Cox proportional hazard models showed an association between increased risk of cardiovascular event incidence and prolonged cumulative low-income status [1 or 2 years: hazard ratio (HR) = 1.27, 95% confidence interval (CI) = 0.97\u20131.67; 3 years: HR = 1.33, 95% CI = 1.01\u20131.77; P for trend = 0.045]. A generalized structural equation model revealed that engagement in negative health behaviour mediated the longitudinal relationship between 1 and 2 years of cumulative low-income status and cardiovascular event incidence (indirect effect estimate = 0.179, P-value = 0.004).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings suggest that interventions targeting engagement in health behaviour among population with cumulative low-income status may help prevent cardiovascular events and promote cardiovascular health equity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjcn\/zvaf189","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T12:06:57Z","timestamp":1758802017000},"page":"343-351","source":"Crossref","is-referenced-by-count":1,"title":["Association between cumulative low-income status and cardiovascular event incidence and mediating effect of engagement in health behaviour: a retrospective cohort study"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1835-3352","authenticated-orcid":false,"given":"Sun Young","family":"Shim","sequence":"first","affiliation":[{"name":"Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing , 50 Yonsei-ro, Seodaemun-gu, Seoul 03722 ,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9558-7737","authenticated-orcid":false,"given":"Hyeonkyeong","family":"Lee","sequence":"additional","affiliation":[{"name":"Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing , 50 Yonsei-ro, Seodaemun-gu, Seoul 03722 ,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4694-0359","authenticated-orcid":false,"given":"Mona","family":"Choi","sequence":"additional","affiliation":[{"name":"Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing , 50 Yonsei-ro, Seodaemun-gu, Seoul 03722 ,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7867-1240","authenticated-orcid":false,"given":"Hyeon Chang","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Yonsei University College of Medicine , 50 Yonsei-ro, Seodaemun-gu, Seoul 03722 ,","place":["Republic of Korea"]},{"name":"Institute for Innovation in Digital Healthcare, Yonsei University , 50 Yonsei-ro, Seodaemun-gu, Seoul 03722 ,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3366-4279","authenticated-orcid":false,"given":"Chang Gi","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago , 845 S. 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