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

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,...

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Published in:	Social science & medicine (1982) Vol. 68; no. 3; pp. 444 - 451
Main Authors:	Lemelin, Emily T., Diez Roux, Ana V., Franklin, Tracy G., Carnethon, Mercedes, Lutsey, Pamela L., Ni, Hanyu, O'Meara, Ellen, Shrager, Sandi
Format:	Journal Article
Language:	English
Published:	Kidlington Elsevier Ltd 01-02-2009 Elsevier Pergamon Press Inc
Series:	Social Science & Medicine
Subjects:	Adult Aged Aged, 80 and over Arteriosclerosis Atherosclerosis Atherosclerosis (general aspects, experimental research) Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Carotid Artery Diseases - diagnosis Carotid Artery Diseases - epidemiology Carotid Artery Diseases - ethnology Carotid Artery, Common - physiopathology Censuses Child Chronic illnesses Diseases Ethnicity Female Gender General aspects Health Health Status Disparities Humans Life Change Events Life cycles Life Tables Life-course Male Medical sciences Middle Aged Miscellaneous Multiracial people Neighborhood Neighborhoods Neighbourhoods Population Surveillance Poverty - statistics & numerical data Public health. Hygiene Public health. Hygiene-occupational medicine Residence Characteristics - classification Risk factors Sex Social Class Socioeconomic Factors Socioeconomic position Socioeconomic position Subclinical disease Life-course USA Neighborhood Atherosclerosis Ethnicity Gender Socioeconomic Status Subclinical disease Tunica Intima - physiopathology U.S.A United States - epidemiology USA United States North America America United States > US USA USA Ethnicity Life-course Atherosclerosis Subclinical disease Gender Socioeconomic position Neighborhood Human Social influence Ethnic origin Socioeconomic status Disease Sex Cardiovascular disease Asymptomatic Residential neighborhoods Ethnic group Vascular disease Social medicine Economic aspect Social aspect Public health
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Summary:	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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	0277-9536 1873-5347
DOI:	10.1016/j.socscimed.2008.10.038