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生命历程中的社会经济地位与心血管疾病风险:种族/民族和性别的异质性

Life course SES and cardiovascular risk: Heterogeneity across race/ethnicity and gender.

作者信息

Walsemann Katrina M, Goosby Bridget J, Farr Deeonna

机构信息

Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene Street, Room 529, Columbia, SC 29208, USA.

Department of Sociology, University of Nebraska-Lincoln, 741 Oldfather Hall, Lincoln, NE 68588, USA.

出版信息

Soc Sci Med. 2016 Mar;152:147-55. doi: 10.1016/j.socscimed.2016.01.038. Epub 2016 Jan 26.

Abstract

We examine four life course models as they relate to adolescent SES, adult SES, and cardiovascular risk--the sensitive period, pathways, accumulation, and social mobility models. Accounting for race/ethnic and gender differences in life course processes, we analyzed Waves I and IV of the National Longitudinal Study of Adolescent to Adult Health, a nationally representative sample of individuals enrolled in grades 7-12 when they were first interviewed in 1994/5. We restricted our sample to whites, blacks, and Latinos who were interviewed in Waves I and IV and provided biomarker data (n = 11,397). The cardiovascular risk score at Wave IV combined waist circumference, blood pressure, hemoglobin A1c, and C-reactive protein. We found evidence for each of the four life course models for white women, whereas the sensitive period was indicated for white men. Upward mobility was also associated with higher CVD risk among white men as compared to those who were socio-economically advantaged at both time points. The pathway model was significant for Latino women. No life course models were significant for black men or women or Latino men. Our findings demonstrate the importance of applying an intersectional lens to understanding CVD risk over the life course.

摘要

我们研究了四种与青少年社会经济地位(SES)、成人SES和心血管疾病风险相关的生命历程模型——敏感期模型、路径模型、累积模型和社会流动模型。考虑到生命历程过程中的种族/民族和性别差异,我们分析了全国青少年健康纵向研究的第一波和第四波数据,该研究是一个具有全国代表性的样本,于1994/1995年首次接受访谈时,研究对象为7至12年级的学生。我们将样本限制为在第一波和第四波中接受访谈并提供生物标志物数据的白人、黑人和拉丁裔(n = 11397)。第四波的心血管疾病风险评分综合了腰围、血压、糖化血红蛋白和C反应蛋白。我们发现白人女性存在支持这四种生命历程模型中每一种的证据,而白人男性显示出敏感期模型的证据。与在两个时间点都具有社会经济优势的男性相比,白人男性中的向上流动也与更高的心血管疾病风险相关。路径模型对拉丁裔女性具有显著性。对于黑人男性或女性以及拉丁裔男性,没有生命历程模型具有显著性。我们的研究结果表明,应用交叉视角来理解生命历程中的心血管疾病风险具有重要意义。

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