This multilevel study showed that SES of municipalities has independent influence on risk of mortality among individuals living in these areas. Not only individual but also regional SES could be social determinants of health. Introduction: Cardiovascular disease (CVD) is associated with high morbidity and mortality rates in the U.S. Negative associations between CVD and socioeconomic (SES) are well established. Socioeconomic status, generally defined by factors such as income, education and occupation, can be measured subjectively via-self report using a scale representing a ten rung ladder.