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Life-course socioeconomic positions and subclinical atherosclerosis in the multi-ethnic study of atherosclerosis

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  • Lemelin, Emily T.
  • Diez Roux, Ana V.
  • Franklin, Tracy G.
  • Carnethon, Mercedes
  • Lutsey, Pamela L.
  • Ni, Hanyu
  • O'Meara, Ellen
  • Shrager, Sandi

Abstract

A major limitation of past work on the social patterning of atherosclerosis has been the reliance on measures of neighborhood or individual-level socioeconomic position (SEP) assessed at a single point in time in adulthood. Risk of chronic disease is thought to accumulate throughout the life-course, so the use of a measure for a single point in time may result in inaccurate estimates of the social patterning of subclinical disease. Using data from the US Multi-Ethnic Study of Atherosclerosis (MESA), we examined the relation between childhood SEP [CSEP] (father or caretaker's education), adulthood SEP [ASEP] (a summary score of income, education, and wealth), and 20-year average exposure to neighborhood poverty [NSEP] (residential addresses geocoded and linked to census data) and the prevalence of subclinical atherosclerosis, as assessed by common carotid intimal-medial thickness (IMT) in mid to late adulthood. Participants were 45-84 years of age at baseline and were sampled from six study sites in the United States. After adjustment for age, CSEP and ASEP were both inversely and independently associated with IMT in men. All three indicators CSEP, ASEP, and NSEP were inversely and independently associated with IMT in women. Associations were somewhat reduced after adjustment for cardiovascular risk factors, suggesting that these factors may play a mediating role. There was evidence of heterogeneity in effects of NSEP by gender, and in the effects of ASEP and NSEP by race/ethnicity. Our results contribute to the growing body of work that shows that SEP at multiple points in the life-course, and at the individual and neighborhood level, contributes to the development of atherosclerosis.

Suggested Citation

  • Lemelin, Emily T. & Diez Roux, Ana V. & Franklin, Tracy G. & Carnethon, Mercedes & Lutsey, Pamela L. & Ni, Hanyu & O'Meara, Ellen & Shrager, Sandi, 2009. "Life-course socioeconomic positions and subclinical atherosclerosis in the multi-ethnic study of atherosclerosis," Social Science & Medicine, Elsevier, vol. 68(3), pages 444-451, February.
  • Handle: RePEc:eee:socmed:v:68:y:2009:i:3:p:444-451
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    References listed on IDEAS

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    1. repec:aph:ajpbhl:2003:93:11:1939-1944_1 is not listed on IDEAS
    2. Nordstrom, Cheryl K. & Diez Roux, Ana V. & Jackson, Sharon A. & Gardin, Julius M., 2004. "The association of personal and neighborhood socioeconomic indicators with subclinical cardiovascular disease in an elderly cohort. The cardiovascular health study," Social Science & Medicine, Elsevier, vol. 59(10), pages 2139-2147, November.
    3. repec:aph:ajpbhl:10.2105/ajph.2006.087734_5 is not listed on IDEAS
    4. Stafford, M. & Cummins, S. & Macintyre, S. & Ellaway, A. & Marmot, M., 2005. "Gender differences in the associations between health and neighbourhood environment," Social Science & Medicine, Elsevier, vol. 60(8), pages 1681-1692, April.
    5. Hallqvist, Johan & Lynch, John & Bartley, Mel & Lang, Thierry & Blane, David, 2004. "Can we disentangle life course processes of accumulation, critical period and social mobility? An analysis of disadvantaged socio-economic positions and myocardial infarction in the Stockholm Heart Ep," Social Science & Medicine, Elsevier, vol. 58(8), pages 1555-1562, April.
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    Citations

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    Cited by:

    1. Oshio, Takashi & Umeda, Maki & Fujii, Mayu, 2012. "The mediating effects of adulthood socioeconomic status and social support on adulthood impacts of childhood poverty in Japan," CIS Discussion paper series 538, Center for Intergenerational Studies, Institute of Economic Research, Hitotsubashi University.
    2. Walsemann, Katrina M. & Goosby, Bridget J. & Farr, Deeonna, 2016. "Life course SES and cardiovascular risk: Heterogeneity across race/ethnicity and gender," Social Science & Medicine, Elsevier, vol. 152(C), pages 147-155.
    3. Fujishiro, Kaori & Xu, Jun & Gong, Fang, 2010. "What does "occupation" represent as an indicator of socioeconomic status?: Exploring occupational prestige and health," Social Science & Medicine, Elsevier, vol. 71(12), pages 2100-2107, December.
    4. Matthews, Karen A. & Schwartz, Joseph E. & Cohen, Sheldon, 2011. "Indices of socioeconomic position across the life course as predictors of coronary calcification in black and white men and women: Coronary artery risk development in young adults study," Social Science & Medicine, Elsevier, vol. 73(5), pages 768-774, September.
    5. Camelo, Lidyane V. & Giatti, Luana & Chor, Dóra & Griep, Rosane Härter & Benseñor, Isabela M. & Santos, Itamar S. & Kawachi, Ichiro & Barreto, Sandhi Maria, 2015. "Associations of life course socioeconomic position and job stress with carotid intima-media thickness. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)," Social Science & Medicine, Elsevier, vol. 141(C), pages 91-99.

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