Pathways by Which SES and Ethnicity Influence Cardiovascular Disease Risk Factors

Abstract: Little is known about pathways by which socioeconomic status (SES) translates into individual differences in cardiovascular disease (CVD) risk factors. Because the socioeconomic structure is not the same for all ethnic subgroups, the pathways that lead to the development of CVD risk factors may vary by both SES and ethnicity. We used data from a large national survey to examine the independent associations of two indicators of SES (education and income) and ethnicity with six primary CVD risk factors. We then used data on smoking that reflected a temporal sequence to examine the extent to which SES and ethnicity influenced smoking at three different time points, from smoking onset, to a serious quit attempt, to successful quitting. These analyses provide an understanding of the relationships between SES, ethnicity, and CVD risk factors and suggest that if the timing, focus, and content of intervention programs take pathways into account they will result in more successful outcomes.

[1]  Michael Witt,et al.  SUDAAN User's Manual, Release 9.0 , 2002 .

[2]  H. Kraemer,et al.  Ethnic variation in cardiovascular disease risk factors among children and young adults: findings from the Third National Health and Nutrition Examination Survey, 1988-1994. , 1999, JAMA.

[3]  H. Kraemer,et al.  Ethnic and socioeconomic differences in cardiovascular disease risk factors: findings for women from the Third National Health and Nutrition Examination Survey, 1988-1994. , 1998, JAMA.

[4]  R. Gillum,et al.  Coronary heart disease risk factors and attributable risks in African-American women and men: NHANES I epidemiologic follow-up study. , 1998, American journal of public health.

[5]  M. Winkleby,et al.  Concerns and Misconceptions about Cardiovascular Disease Risk Factors: A Focus Group Evaluation with Low-Income Hispanic Women , 1998 .

[6]  E. Gilpin,et al.  Tobacco industry promotion of cigarettes and adolescent smoking. , 1998, JAMA.

[7]  M. Winkleby Accelerating cardiovascular risk factor change in ethnic minority and low socioeconomic groups , 1997 .

[8]  B Barnwell,et al.  SUDAAN User's Manual, Release 7.5, , 1997 .

[9]  D. Murray,et al.  Joint analysis of three U.S. community intervention trials for reduction of cardiovascular disease risk. , 1997, Journal of clinical epidemiology.

[10]  R. Kington,et al.  DataBase: Research and Evaluation Results , 1997, American journal of public health.

[11]  H. Kraemer,et al.  Coming to terms with the terms of risk. , 1997, Archives of general psychiatry.

[12]  D. Labarthe,et al.  Greater incidence of hospitalized myocardial infarction among Mexican Americans than non-Hispanic whites. The Corpus Christi Heart Project, 1988-1992. , 1997, Circulation.

[13]  S. Haffner,et al.  Effects of cigarette smoking, diabetes, high cholesterol, and hypertension on all-cause mortality and cardiovascular disease mortality in Mexican Americans. The San Antonio Heart Study. , 1996, American journal of epidemiology.

[14]  J. Salonen,et al.  Do cardiovascular risk factors explain the relation between socioeconomic status, risk of all-cause mortality, cardiovascular mortality, and acute myocardial infarction? , 1996, American journal of epidemiology.

[15]  S. Syme,et al.  Rethinking disease: where do we go from here? , 1996, Annals of epidemiology.

[16]  N. Anderson,et al.  Macrosocial and environmental influences on minority health. , 1995, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[17]  David R. Williams,et al.  Panel II: Macrosocial and environmental influences on minority health. , 1995 .

[18]  N. Anderson Behavioral and sociocultural perspectives on ethnicity and health: introduction to the special issue. , 1995, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[19]  S. Fortmann,et al.  Community intervention trials: reflections on the Stanford Five-City Project Experience. , 1995, American journal of epidemiology.

[20]  S. Greenland Fractional expected numbers. , 1995, Epidemiology.

[21]  M. Szklo,et al.  Social inequalities and atherosclerosis. The atherosclerosis risk in communities study. , 1995, American journal of epidemiology.

[22]  M. Lillie-Blanton,et al.  Conducting an assessment of health needs and resources in a racial/ethnic minority community. , 1995, Health services research.

[23]  N Krieger,et al.  Epidemiology and the web of causation: has anyone seen the spider? , 1994, Social science & medicine.

[24]  M. Winkleby The future of community-based cardiovascular disease intervention studies. , 1994, American journal of public health.

[25]  R. Carleton,et al.  Education and risk factors for coronary heart disease: results from a New England community. , 1993, American journal of preventive medicine.

[26]  Robert Murphy,et al.  Socioeconomic Status and Coronary Heart Disease Risk Factor Trends The Minnesota Heart Survey , 1993, Circulation.

[27]  S. Traub,et al.  Evaluating Medical Tests: Objective and Quantitative Guidelines , 1993 .

[28]  J E Keil,et al.  Socioeconomic factors and cardiovascular disease: a review of the literature. , 1993, Circulation.

[29]  S. Fortmann,et al.  Changes in coronary heart disease risk factors in the 1980s: evidence of a male-female crossover effect with age. , 1993, American journal of epidemiology.

[30]  T D Koepsell,et al.  The effect of matching on the power of randomized community intervention studies. , 1993, Statistics in medicine.

[31]  S. Fortmann,et al.  Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. , 1992, American journal of public health.

[32]  C. Basch,et al.  Independent associations of educational attainment and ethnicity with behavioral risk factors for cardiovascular disease. , 1991, American journal of epidemiology.

[33]  J. House,et al.  Age, socioeconomic status, and health. , 1990, The Milbank quarterly.

[34]  L. Schorr,et al.  Within Our Reach: Breaking the Cycle of Disadvantage , 1989 .

[35]  J. Feldman,et al.  National trends in educational differentials in mortality. , 1989, American journal of epidemiology.

[36]  S. Cummings,et al.  Optimum cutoff points for biochemical validation of smoking status. , 1988, American journal of public health.

[37]  M. Marmot,et al.  MORTALITY DECLINE AND WIDENING SOCIAL INEQUALITIES , 1986, The Lancet.

[38]  W. Watson,et al.  SOCIOLOGY IN MEDICINE , 1963, The Ulster Medical Journal.

[39]  David R. Williams,et al.  Us socioeconomic and racial differences in health: patterns and explanations , 1995 .

[40]  Bruce G. Link,et al.  Social conditions as fundamental causes of disease. , 1995, Journal of health and social behavior.

[41]  D. Williams,et al.  The concept of race and health status in America. , 1994, Public health reports.

[42]  Plan and operation of the Third National Health and Nutrition Examination Survey, 1988-94. Series 1: programs and collection procedures. , 1994, Vital and health statistics. Ser. 1, Programs and collection procedures.

[43]  S. Wing,et al.  Increasing inequality in coronary heart disease mortality in relation to educational achievement: Profile of places of residence, United States, 1962 to 1987 , 1993 .

[44]  Paul Elliott,et al.  Coronary heart disease epidemiology : from aetiology to public health , 1992 .

[45]  D. Bell,et al.  Faces at the Bottom of the Well , 1992 .

[46]  A. Geronimus,et al.  The weathering hypothesis and the health of African-American women and infants: evidence and speculations. , 1992, Ethnicity & disease.

[47]  Derrick Bell,et al.  Faces at the bottom of the well : the permanence of racism , 1992 .

[48]  S. Fortmann,et al.  Social class disparities in risk factors for disease: eight-year prevalence patterns by level of education. , 1990, Preventive medicine.

[49]  J L Kelsey,et al.  The measurement of social class in epidemiology. , 1988, Epidemiologic reviews.

[50]  L. Wallack,et al.  Primary prevention: a new look at basic concepts. , 1987, Social science & medicine.

[51]  Man-Huei Chang,et al.  Inflammation gene variants and susceptibility to albuminuria in the U.S. population: analysis in the Third National Health and Nutrition Examination Survey (NHANES III), 1991-1994 , 2010, BMC Medical Genetics.