Life-Course Socioeconomic Position and Incidence of Coronary Heart Disease : The Framingham Offspring Study

Cumulative exposure to socioeconomic disadvantage across the life course may be inversely associated with coronary heart disease (CHD); the mechanisms are not fully clear. An objective of this study was to determine whether cumulative life-course socioeconomic position (SEP) is associated with CHD i...

Full description

Saved in:
Bibliographic Details
Published in:American journal of epidemiology 2009-04, Vol.169 (7), p.829-836
Main Authors: LOUCKS, Eric B, LYNCH, John W, PILOTE, Louise, FUHRER, Rebecca, ALMEIDA, Nisha D, RICHARD, Hugues, AGHA, Golareh, MURABITO, Joanne M, BENJAMIN, Emelia J
Format: Article
Language:English
Subjects:
Adult
Analysis. Health state
Biological and medical sciences
Cardiology. Vascular system
Cardiovascular disease
Coronary Disease - epidemiology
Coronary Disease - etiology
Coronary heart disease
Educational Status
Epidemiology
Female
General aspects
Heart
Humans
Incidence
Lifestyles
Male
Medical sciences
Middle Aged
Miscellaneous
Myocarditis. Cardiomyopathies
Occupations
Original Contributions
Parents
Proportional Hazards Models
Public health. Hygiene
Public health. Hygiene-occupational medicine
Risk Factors
Socioeconomic Factors
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Cumulative exposure to socioeconomic disadvantage across the life course may be inversely associated with coronary heart disease (CHD); the mechanisms are not fully clear. An objective of this study was to determine whether cumulative life-course socioeconomic position (SEP) is associated with CHD incidence in a well-characterized US cohort that had directly assessed childhood and adulthood measures of SEP and prospectively measured CHD incidence. Furthermore, analyses aimed to evaluate whether adjustment for CHD risk factors reduces the association between cumulative life-course SEP and CHD. The authors examined 1,835 subjects who participated in the Framingham Heart Study Offspring Cohort from 1971 through 2003 (mean age, 35.0 years; 52.4% women). Childhood SEP was measured as father's education; adulthood SEP was assessed as own education and occupation. CHD incidence included myocardial infarction, coronary insufficiency, and coronary death. Cox proportional hazards analyses indicated that cumulative SEP was associated with incident CHD after adjustment for age and sex (hazard ratio = 1.82, 95% confidence interval: 1.17, 2.85 for low vs. high cumulative SEP score). Adjustment for CHD risk factors reduced that magnitude of association (hazard ratio = 1.29, 95% confidence interval: 0.78, 2.13). These findings underscore the potential importance of CHD prevention and treatment efforts for those whose backgrounds include low SEP throughout life.
ISSN:0002-9262
1476-6256
DOI:10.1093/aje/kwn403