Race disparities in cardiovascular disease risk factors within socioeconomic status strata

Intensive gestational glycemic management and childhood obesity: a systematic review and meta-analysis

“…98 Socioeconomic affluence has a considerable impact on housing quality 101 and food security 97 , two factors that may have a notable influence on diabetes and CVD risk through stress, environmental exposures, and diet quality. 97,101 Finally, this marker is also associated with breastfeeding initiation, duration, and exclusivity 99,102,103 as well as with educational attainment 104 . Thus, socioeconomic status may be an important mediator in the association between intrauterine exposure to diabetes and future risk of CVD and will be considered as a potential confounder in our analyses whenever possible.…”

“…This may be why our results, carefully adjusted for socioeconomic variables, do not support an independent effect of breastfeeding initiation on cardiovascular risk up to 28 years after birth, irrespective of intrauterine exposure to diabetes.Higher education attainment is associated with lower prevalence of CVD in adults89,115,226 , with effect sizes ranging between an unadjusted 6.7-fold difference in prevalence between nonhigh school graduates vs graduates227 to an odds ratio of 2.64 (95%CI 2.16-3.22) after adjustments for age, sex, and race for elementary school graduates vs college graduates 228. Using a retrospective cohort, Bell et al did not find a significant association between high school completion and risk for hypertension, diabetes and hypercholesterolemia in 20-year olds participating in the National Health and Nutritional Examination Surveys (NHANES) between 2007 and 2014 104. However, college completion was significantly protective towards hypertension with an effect size similar to ours after adjustment for current income (as well as other potential confounders including sex and age; odds ratio 0.72, 95%CI 0.59-0.89104 ).…”

“…Using a retrospective cohort, Bell et al did not find a significant association between high school completion and risk for hypertension, diabetes and hypercholesterolemia in 20-year olds participating in the National Health and Nutritional Examination Surveys (NHANES) between 2007 and 2014 104. However, college completion was significantly protective towards hypertension with an effect size similar to ours after adjustment for current income (as well as other potential confounders including sex and age; odds ratio 0.72, 95%CI 0.59-0.89104 ). Our results extend the existing literature by prospectively evaluating the protective effect of high school completion in a population-based sample of offspring exposed to diabetes in utero.…”

The Price of the Ticket: Health Costs of Upward Mobility among African Americans

“…Not only do these costs exact a toll on the quality of interpersonal interactions that Black Americans engage in over the life course, researchers have demonstrated that these costs likely diminish the social, economic and health returns on the human capital investments of Black Americans [7][8][9][10]. For example, Bell and colleagues found a greater obesity burden among African Americans with greater incomes (≥$100,000) and those who had completed college [11]. In accordance with the diminishing returns hypothesis, they argue that it is possible that African Americans experience fewer health-related benefits of greater levels of income and education compared with whites.…”

Assessing the Role of Health Behaviors, Socioeconomic Status, and Cumulative Stress for Racial/Ethnic Disparities in Obesity

“…In contrast, in households with incomes 350% above the federal poverty level, the obesity prevalence for non‐Hispanic Black individuals is approximately 49% compared with 31% for non‐Hispanic White individuals . Bell and colleagues found that racial disparities in obesity between African American ( n = 3,950) and non‐Hispanic White ( n = 8,777) adults are largest in the highest income (≥ $100,000) and education (college graduate or more) groups. The persistent racial/ethnic inequalities in obesity across every gradient of the SEP strata suggest that other factors contribute to the persistent racial/ethnic disparities in obesity in the US.…”