The association of personal and neighborhood socioeconomic indicators with subclinical cardiovascular disease in an elderly cohort. The cardiovascular health study.

Department of Epidemiology, School of Public Health, University of Michigan, 1214 S. 2nd Floor, Ann Arbor, MI 48104-2548, USA.
Social Science & Medicine (Impact Factor: 2.56). 12/2004; 59(10):2139-47. DOI: 10.1016/j.socscimed.2004.03.017
Source: PubMed

ABSTRACT There has been recent interest in determining whether neighborhood characteristics are related to the cardiovascular health of residents. However, there are no data regarding the relationship between neighborhood socioeconomic status (SES) and prevalence of subclinical cardiovascular disease (CVD) in the elderly. We related personal SES (education, income, and occupation type) and neighborhood socioeconomic characteristics (a block-group score summing six variables reflecting neighborhood income and wealth, education, and occupation) to the prevalence of subclinical CVD (asymptomatic peripheral vascular disease or carotid atherosclerosis, electrocardiogram or echocardiogram abnormalities, and/or positive responses to Rose Questionnaire claudication or angina pectoris) among 3545 persons aged 65 and over, without prevalent CVD, in the Cardiovascular Health Study. Sixty percent of participants had at least one indicator of subclinical disease. Compared to those without, those with subclinical disease had significantly lower education, income, and neighborhood scores and were more likely to have blue-collar jobs. After adjustment for age, gender, and race, those in the lowest SES groups had increased prevalence of subclinical disease compared with those in the highest SES groups (OR = 1.50; 95% CI 1.21, 1.86 for income; OR = 1.41; 95% CI 1.18, 1.69 for education; OR = 1.39; 95% CI 1.16, 1.67 for block-group score). Those reporting a blue-collar lifetime occupation had greater prevalence of subclinical disease relative to those reporting a white-collar occupation (OR = 1.29; 95% CI 1.02-1.59). After adjustment for behavioral and biomedical risk factors, all of these associations were reduced. Neighborhood score tended to remain inversely associated with subclinical disease after adjustment for personal socioeconomic indicators but associations were not statistically significant. Personal income and blue-collar occupation remained significantly associated with subclinical disease after simultaneous adjustment for neighborhood score and education. Personal and neighborhood socioeconomic indicators were associated with subclinical disease prevalence in this elderly cohort. These relationships were reduced after controlling for traditional CVD risk factors.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: It has been widely observed that socioeconomic status (SES) is associated with frequency of cardiovascular disease. Both men and women of low socioeconomic position have increased risk of cardiovascular disease morbidity and premature death. In this study the relationship between SES in childhood, and health status at the age of 50 years was examined. Socioeconomic status in childhood was measured using objective (father's educational level and number of children in the family) and subjective (self-assessed SES in childhood declared in early adulthood) indicators. Data from the Wroclaw Growth Study were completed when subjects were 50 years old, and information concerning health status was added. The results indicated that the objective, universally used measures of SES in childhood such as father's educational level and size of family did not show any essential relationships with health outcomes in adulthood, both for men and women. By contrast, retrospective, self-assessed SES (as better, average or worse as compared with peers) in childhood was significantly associated with the appearance of cardiovascular disease among women aged 50 years. Women who at the beginning of their adult life declared better socioeconomic condition in childhood were significantly healthier at the age of 50 years (OR=3.43; p=0.02). Moreover, this appeared to be independent of BMI, SES and life-style in adulthood. For men, retrospective self-assessed SES showed no relation to health status at the age of 50 years. The gender differences in the relationships between self-assessed SES in childhood and health status in adulthood are explained by possible selective premature mortality among men from lower childhood SES and/or sex differences in cognitive abilities.
    Journal of Biosocial Science 08/2007; 39(4):481-91. DOI:10.1017/S0021932006001799 · 0.98 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The study examines the association of neighborhood socioeconomic deprivation and metabolic syndrome with inflammation. The analysis included 19, 079 black and white participants from the REasons for Geographic And Racial Differences in Stroke Study who were age > 45 years at baseline. Logistic regression examined whether neighborhood deprivation was associated with increased odds of METS and CRP-MetS. Among black adults, residing in the most deprived neighborhoods was associated with increased odds of obesity (p < .01), lower HDL (p < .001), high blood pressure (p < .01), elevated fasting glucose (p < .001), inflammation (p < .01), and CRP-MetS (p < .001). Among white adults, neighborhood deprivation was associated with higher waist circumference (p < .001), lower HDL (p < .001), higher triglycerides (p < .01), higher glucose (p < .001), higher BMI (p < .0001), higher blood pressure (p = .01), METS (p < .001), inflammation (p < .01) and CRP-MetS (p < .001). These findings highlight the role of neighborhood socioeconomic deprivation on METS and CRP-MetS for black and white adults. Interventions tailored to address the contextual effects of deprived neighborhoods may reduce the observed neighborhood disparities.
    BMC Public Health 12/2014; 14(1):1319. DOI:10.1186/1471-2458-14-1319 · 2.32 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Low neighborhood-level socioeconomic status has been associated with poorer health, reduced physical activity, increased psychological stress, and less neighborhood-based social support. These outcomes are correlates of late life cognition, but few studies have specifically investigated the neighborhood as a unique source of explanatory variance in cognitive aging. This study supplemented baseline cognitive data from the ACTIVE (Advanced Cognitive Training for Independent and Vital Elderly) study with neighborhood-level data to investigate (1) whether neighborhood socioeconomic position (SEP) predicts cognitive level, and if so, whether it differentially predicts performance in general and specific domains of cognition and (2) whether neighborhood SEP predicts differences in response to short-term cognitive intervention for memory, reasoning, or processing speed. Neighborhood SEP positively predicted vocabulary, but did not predict other general or specific measures of cognitive level, and did not predict individual differences in response to cognitive intervention.
    Journal of aging research 08/2012; 2012:435826. DOI:10.1155/2012/435826


Available from