Education differences in cardiometabolic risk in England, Scotland and the United States between 1992 and 2019

Abstract

Background Education differences in cardiometabolic risk and disease still play a major role in the magnitude of the socioeconomic health disparities in high-income societies. However, the knowledge on how education differences may have changed over time regarding the distribution of multiple risk factors is rather limited. This study aims to provide a comprehensive assessment of the magnitude of those differences in three high-income countries. Methods Data from repeated cross-sectional population health and examination surveys conducted between 1992 and 2019 in England, Scotland and the United States are analysed (pooled sample size $$n = 362{,}275$$ n = 362 , 275 ). Six cardiometabolic risk factors, namely, systolic and diastolic blood pressure, body-mass-index, glycated haemoglobin HbA1c, serum total cholesterol and the cardiovascular risk score are analysed with linear mixed models. Results Education differences in cardiometabolic risk were found to have either increased or remained stable for the past 3 decades in the countries included in the analyses. Among individuals with no qualification the cardiometabolic risk has been higher than among the higher educated (mean difference: 0.136, 99% CI [0.119; 0.152]). Education differences were observed also for systolic blood pressure (2.788 mmHg, 99% CI [2.529; 3.047]), glycated haemoglobin HbA1c (0.160 %, 99% CI [0.136; 0.185]), total cholesterol (0.268 mmol/L, 99% CI [0.247; 0.289]) and body-mass-index (0.591 kg/m2, 99% CI [0.504; 0.679]). Conclusion The results suggest a more complex pattern of associations between education and health which may be due to education-dependent processes related to behavioural, cognitive and attitudinal modification and adaptation to changing socio-cultural conditions.

Evaluating the association between the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, mental health, and cardio-metabolic risk factors among individuals with obesity

“…The confounding factors were selected using the following criteria: the exposure was related to the confounder, the outcome was related to the confounder (or the confounding variable was a risk factor or a surrogate risk factor for the outcome), and the confounding variable was not an intermediary variable [ 65 ]. Thus, we selected age [ 66 ], sex [ 67 ], SES [ 68 , 69 ], physical activity [ 70 ], BMI [ 71 ], educational level [ 72 , 73 ], and energy intake [ 74 , 75 ] as the confounding variables since they were associated with cardio-metabolic risk factors. Additionally, we used the same confounding variables for mental health, except for energy intake [ 76 – 78 ].…”

Polyphenols and Cardiometabolic Health: Knowledge and Concern among Romanian People

“…Several studies have shown that an increased education correlates with a lower CMR. In contrast, a low level of education correlates with poor health and a shorter life expectancy, even in developed countries [ 43 , 44 ]. First, an increased level of education correlates with a better and implicitly higher-level job, which facilitates access to preventive and acute medical care.…”

“…Several studies have shown that an increased education correlates with a lower CMR. In contrast, a low level of education correlates with poor health and a shorter life expectancy, even in developed countries [43,44].…”

Whether weekend warriors (WWs) achieve equivalent benefits in lipid accumulation products (LAP) reduction as other leisure-time physical activity patterns? -Results from a population-based analysis of NHANES 2007–2018

“…Given that regular exercise per se was one of the most effective interventional strategies to control diabetes and combating obesity, being RA may obtain more pronounced LAP reduction in obese individuals with diabetes. Besides, Diego Montano has reported that cardiometabolic risk was tightly associated with education differences, individuals with lower education levels got significantly higher cardiometabolic risk compared with those who were higher educated [ 49 ]. Education differences were found in multiple obesity-related indexes, including glycated haemoglobin, total cholesterol and BMI [ 49 ].…”

“…Besides, Diego Montano has reported that cardiometabolic risk was tightly associated with education differences, individuals with lower education levels got significantly higher cardiometabolic risk compared with those who were higher educated [ 49 ]. Education differences were found in multiple obesity-related indexes, including glycated haemoglobin, total cholesterol and BMI [ 49 ]. Education may modify the association between PA pattern and LAP in a rather complexed way, possibly via modulating the behavior, attitude and adaptation to PA.…”