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Education, income and ethnic differences in cumulative biological risk profiles in a national sample of US adults: NHANES III (1988-1994)


  • Seeman, Teresa
  • Merkin, Sharon S.
  • Crimmins, Eileen
  • Koretz, Brandon
  • Charette, Susan
  • Karlamangla, Arun


Data from the nationally representative US National Health and Nutrition Examination Survey (NHANES) III cohort were used to examine the hypothesis that socio-economic status is consistently and negatively associated with levels of biological risk, as measured by nine biological parameters known to predict health risks (diastolic and systolic blood pressure, pulse, HDL and total cholesterol, glycosylated hemoglobin, c-reactive protein, albumin and waist-hip ratio), resulting in greater cumulative burdens of biological risk among those of lower education and/or income. As hypothesized, consistent education and income gradients were seen for biological parameters reflecting cardiovascular, metabolic and inflammatory risk: those with lower education and income exhibiting greater prevalence of high-risk values for each of nine individual biological risk factors. Significant education and income gradients were also seen for summary indices reflecting cumulative burdens of cardiovascular, metabolic and inflammatory risks as well as overall total biological risks. Multivariable cumulative logistic regression models revealed that the education and income effects were each independently and negatively associated with cumulative biological risks, and that these effects remained significant independent of age, gender, ethnicity and lifestyle factors such as smoking and physical activity. There were no significant ethnic differences in the patterns of association between socio-economic status and biological risks, but older age was associated with significantly weaker education and income gradients.

Suggested Citation

  • Seeman, Teresa & Merkin, Sharon S. & Crimmins, Eileen & Koretz, Brandon & Charette, Susan & Karlamangla, Arun, 2008. "Education, income and ethnic differences in cumulative biological risk profiles in a national sample of US adults: NHANES III (1988-1994)," Social Science & Medicine, Elsevier, vol. 66(1), pages 72-87, January.
  • Handle: RePEc:eee:socmed:v:66:y:2008:i:1:p:72-87

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    References listed on IDEAS

    1. Kington, R.S. & Smith, J.P., 1997. "Socioeconomic status and racial and ethnic differences in functional status associated with chronic diseases," American Journal of Public Health, American Public Health Association, vol. 87(5), pages 805-810.
    2. Seeman, Teresa E. & Crimmins, Eileen & Huang, Mei-Hua & Singer, Burton & Bucur, Alexander & Gruenewald, Tara & Berkman, Lisa F. & Reuben, David B., 2004. "Cumulative biological risk and socio-economic differences in mortality: MacArthur Studies of Successful Aging," Social Science & Medicine, Elsevier, vol. 58(10), pages 1985-1997, May.
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    4. repec:aph:ajpbhl:10.2105/ajph.2004.060749_0 is not listed on IDEAS
    5. James Smith, 2004. "Unravelling the SES health connection," IFS Working Papers W04/02, Institute for Fiscal Studies.
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    1. Michaud, Pierre-Carl & Crimmins, Eileen M. & Hurd, Michael D., 2016. "The effect of job loss on health: Evidence from biomarkers," Labour Economics, Elsevier, vol. 41(C), pages 194-203.
    2. Glei, Dana A. & Goldman, Noreen & Shkolnikov, Vladimir M. & Jdanov, Dmitri & Shalnova, Svetlana & Shkolnikova, Maria & Weinstein, Maxine, 2013. "To what extent do biomarkers account for the large social disparities in health in Moscow?," Social Science & Medicine, Elsevier, vol. 77(C), pages 164-172.
    3. William N. Evans & Timothy J. Moore, 2009. "Liquidity, Activity, Mortality," NBER Working Papers 15310, National Bureau of Economic Research, Inc.
    4. repec:spr:demogr:v:54:y:2017:i:3:d:10.1007_s13524-017-0565-3 is not listed on IDEAS
    5. Hudson, Darrell L. & Puterman, Eli & Bibbins-Domingo, Kirsten & Matthews, Karen A. & Adler, Nancy E., 2013. "Race, life course socioeconomic position, racial discrimination, depressive symptoms and self-rated health," Social Science & Medicine, Elsevier, vol. 97(C), pages 7-14.
    6. Fox, Molly & Thayer, Zaneta & Wadhwa, Pathik D., 2017. "Assessment of acculturation in minority health research," Social Science & Medicine, Elsevier, vol. 176(C), pages 123-132.
    7. Arber, Sara & Bote, Marcos & Meadows, Robert, 2009. "Gender and socio-economic patterning of self-reported sleep problems in Britain," Social Science & Medicine, Elsevier, vol. 68(2), pages 281-289, January.
    8. Boyd-Swan, Casey & Herbst, Chris M. & Ifcher, John & Zarghamee, Homa, 2013. "The Earned Income Tax Credit, Health, and Happiness," IZA Discussion Papers 7261, Institute for the Study of Labor (IZA).
    9. Gruenewald, Tara L. & Karlamangla, Arun S. & Hu, Perry & Stein-Merkin, Sharon & Crandall, Carolyn & Koretz, Brandon & Seeman, Teresa E., 2012. "History of socioeconomic disadvantage and allostatic load in later life," Social Science & Medicine, Elsevier, vol. 74(1), pages 75-83.
    10. Mattei, Josiemer & Demissie, Serkalem & Falcon, Luis M. & Ordovas, Jose M. & Tucker, Katherine, 2010. "Allostatic load is associated with chronic conditions in the Boston Puerto Rican Health Study," Social Science & Medicine, Elsevier, vol. 70(12), pages 1988-1996, June.
    11. Smith, William C. & Anderson, Emily & Salinas, Daniel & Horvatek, Renata & Baker, David P., 2015. "A meta-analysis of education effects on chronic disease: The causal dynamics of the Population Education Transition Curve," Social Science & Medicine, Elsevier, vol. 127(C), pages 29-40.
    12. Kavanagh, Anne & Bentley, Rebecca J. & Turrell, Gavin & Shaw, Jonathan & Dunstan, David & Subramanian, S.V., 2010. "Socioeconomic position, gender, health behaviours and biomarkers of cardiovascular disease and diabetes," Social Science & Medicine, Elsevier, vol. 71(6), pages 1150-1160, September.
    13. Samir KC & Harold Lentzner, 2010. "The effect of education on adult mortality and disability: a global perspective," Vienna Yearbook of Population Research, Vienna Institute of Demography (VID) of the Austrian Academy of Sciences in Vienna, vol. 8(1), pages 201-235.
    14. Szanton, Sarah L. & Thorpe, Roland J. & Whitfield, Keith, 2010. "Life-course financial strain and health in African-Americans," Social Science & Medicine, Elsevier, vol. 71(2), pages 259-265, July.
    15. Theall, Katherine P. & Brett, Zoë H. & Shirtcliff, Elizabeth A. & Dunn, Erin C. & Drury, Stacy S., 2013. "Neighborhood disorder and telomeres: Connecting children's exposure to community level stress and cellular response," Social Science & Medicine, Elsevier, vol. 85(C), pages 50-58.
    16. Damaske, Sarah & Zawadzki, Matthew J. & Smyth, Joshua M., 2016. "Stress at work: Differential experiences of high versus low SES workers," Social Science & Medicine, Elsevier, vol. 156(C), pages 125-133.


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