Socioeconomic Status and Cardiovascular Disease: an Update

Mestral, Carlos de; Stringhini, Silvia

doi:10.1007/s11886-017-0917-z

Cited by 152 publications

(124 citation statements)

References 124 publications

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“…A prospective study is needed to confirm the observed associations and to evaluate whether individual or neighborhood SES are most closely related to changes in CVH over time. Our findings are consistent with studies that have reported an inverse relationship between SES and CVD, particularly in high-income countries [10,25,26]. Beyond being consistent with other studies, our findings suggest a potential causal pathway for disparities in CVD among vulnerable populations.…”

Section: Discussionsupporting

confidence: 93%

“…Individual-level SES can also influence the type of health insurance a person can afford and thus the quality of health care they are able to access. Meanwhile, persons living in areas of lower SES often have lower health literacy as well as a decreased availability of healthy foods, safe places to exercise, and health care accessibility as compared to persons living in areas of higher SES [25,30].…”

Section: Discussionmentioning

confidence: 99%

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Distribution of Cardiovascular Health by Individual- and Neighborhood-Level Socioeconomic Status: Findings From the Jackson Heart Study

Foraker

Bush

Greiner

et al. 2019

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Background: Data demonstrate a positive relationship between socioeconomic status (SES) and cardiovascular health (CVH). Objective: To assess the association between individual-and neighborhood-level SES and CVH among participants of the JHS (Jackson Heart Study), a community-based cohort of African Americans in Jackson, Mississippi. Methods: We included all JHS participants with complete SES and CVH information at the baseline study visit (n ¼ 3,667). We characterized individual-and neighborhood-level SES according to income (primary analysis) and education (secondary analysis), respectively. The outcome of interest for these analyses was a CVH score, based on 7 modifiable behaviors and factors, summed to a total of 0 (worst) to 14 (best) points. We utilized generalized estimating equations to account for the clustering of participants within the same residential areas to estimate the linear association between SES and CVH. Results: The median age of the participants was 55 years, and 64% were women. Nearly one-third of eligible participants had individual incomes <$20,000 and close to 40% lived in the lowest neighborhood income category (<$25,480). Adjusted for age, sex, and neighborhood SES, there was an average increase in CVH score of 0.31 points associated with each 1-category increase in individual income. Similarly, each 1-category increase in neighborhood SES was associated with a 0.19-point increase in CVH score. These patterns held for our secondary analyses, which used educational attainment in place of income. These data did not suggest a synergistic effect of individual-and neighborhood-level SES on CVH. Conclusions: Our findings suggest a potential causal pathway for disparities in CVH among vulnerable populations. These data can be useful to the JHS community to empower public health and clinical interventions and policies for the improvement of CVH.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Distribution of Cardiovascular Health by Individual- and Neighborhood-Level Socioeconomic Status: Findings From the Jackson Heart Study

Foraker

Bush

Greiner

et al. 2019

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“…result of the compounding effects of multiple behavioral and psychosocial risk factors. 25 Furthermore, high cognitive demands contributed to risk predictions of CVD sickness absence, which corroborates previous research on associations between work stress and CVD risk. 9,10 However, work-related variables did not significantly improve the CVD sickness absence risk classification of occupational health survey participants by the FPS.…”

Section: Discussionsupporting

confidence: 87%

Framingham score and work-related variables for predicting cardiovascular disease in the working population

Zwaard

Geraedts

Norder

et al. 2019

European Journal of Public Health

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Background The Framingham score is commonly used to estimate the risk of cardiovascular disease (CVD). This study investigated whether work-related variables improve Framingham score predictions of sickness absence due to CVD. Methods Eleven occupational health survey variables (descent, marital status, education, work type, work pace, cognitive demands, supervisor support, co-worker support, commitment to work, intrinsic work motivation and distress) and the Framingham Point Score (FPS) were combined into a multi-variable logistic regression model for CVD sickness absence during 1-year follow-up of 19 707 survey participants. The Net Reclassification Index (NRI) was used to investigate the added value of work-related variables to the FPS risk classification. Discrimination between participants with and without CVD sickness absence during follow-up was investigated by the area under the receiver operating characteristic curve (AUC). Results A total of 129 (0.7%) occupational health survey participants had CVD sickness absence during 1-year follow-up. Manual work and high cognitive demands, but not the other work-related variables contributed to the FPS predictions of CVD sickness absence. However, work type and cognitive demands did not improve the FPS classification for risk of CVD sickness absence [NRI = 2.3%; 95% confidence interval (CI) −2.7 to 9.5%; P = 0.629]. The FPS discriminated well between participants with and without CVD sickness absence (AUC = 0.759; 95% CI 0.724–0.794). Conclusion Work-related variables did not improve predictions of CVD sickness absence by the FPS. The non-laboratory Framingham score can be used to identify health survey participants at risk of CVD sickness absence.

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“…Recent research has shown that significant disparities exist in the health status of populations as multiple functions of SEP [2]. Importantly, analysis of the influence of SEP on cardiovascular health (CVH) outcomes has been a crucial topic, as cardiovascular disease (CVD) has been the dominant cause of death worldwide for at least 50 years [3].…”

Section: Introductionmentioning

confidence: 99%

Measurement of Socioeconomic Position in Research on Cardiovascular Health Disparities in Korea: A Systematic Review

Lee¹,

Lee²

2019

J Prev Med Public Health

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ObjectivesThe validity of instruments measuring socioeconomic position (SEP) has been a major area of concern in research on cardiovascular health disparities. The purpose of this systematic review is to identify the current status of the methods used to measure SEP in research on cardiovascular health disparities in Korea and to provide directions for future research.MethodsRelevant articles were obtained through electronic database searches with manual searches of reference lists and no restriction on the date of publication. SEP indicators were categorized into compositional, contextual, composite, and life-course measures.ResultsForty-eight studies published from 2003 to 2018 satisfied the review criteria. Studies utilizing compositional measures mainly relied on a limited number of SEP parameters. In addition, these measures hardly addressed the time-varying and subjective features of SEP. Finding valid contextual measures at the organizational, community, and societal levels that are appropriate to Korea’s context remains a challenge, and these are rarely modeled simultaneously. Studies have rarely focused on composite and life-course measures.ConclusionsFuture studies should develop and utilize valid compositional and contextual measures and appraise social patterns that vary across time, place, and culture using such measures. Studies should also consider multilevel influences, adding a focus on the interactions between different levels of intertwined SEP factors to advance the design of research. More attention should be given to composite and life-course measures.

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Socioeconomic Status and Cardiovascular Disease: an Update

Cited by 152 publications

References 124 publications

Distribution of Cardiovascular Health by Individual- and Neighborhood-Level Socioeconomic Status: Findings From the Jackson Heart Study

Distribution of Cardiovascular Health by Individual- and Neighborhood-Level Socioeconomic Status: Findings From the Jackson Heart Study

Framingham score and work-related variables for predicting cardiovascular disease in the working population

Measurement of Socioeconomic Position in Research on Cardiovascular Health Disparities in Korea: A Systematic Review

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