Abstract P639: Sex Modifies the Association of Socioeconomic Status With Life’s Essential 8

Abstract

Introduction: Higher scores for American Heart Association (AHA) Life’s Essential 8 (LE8) metrics, blood pressure, cholesterol, glucose, body mass index, physical activity, smoking, sleep, and diet, are associated with lower risk of chronic disease. Socioeconomic status (SES; education & income) is associated with LE8 metrics, but there is limited understanding of potential differences by sex. Methods: Using data from the continuous National Health and Nutrition Examination Survey, years 2011-2018, LE8 scores were calculated based on AHA guidelines with a point score of 0-100. Age-adjusted linear regression was used to quantify the association of SES with LE8 score. An interaction term was placed in the model to test the interaction of sex with SES in the association with LE8 score among men and women of each racial/ethnic group. Results: The US population representatively weighted sample (n = 13,626) was aged 20 years or older (median 48 years). Non-Hispanic Black and White American (NHBA & NHWA) women had a greater magnitude of positive association of education and income with LE8 scores than men of the same racial groups (p for all interactions < 0.05), due to women having higher LE8 scores at higher education and income levels and no difference between the sexes at low education and income levels. Among non-Hispanic Asian (NHAA) and Hispanic Americans (HA), the association of SES with LE8 was the same in men and women, and women had greater LE8 scores compared to men at all levels of SES (i.e. High school or less, some college, and college degree or more). Conclusions: Women have the greatest magnitude of association of socioeconomic status with LE8 scores among NHBA and NHWA, but not NHAA and HA. Potential explanations for findings in NHBA and NHWA include caregiver burden among women, sex-based discrimination, gender norms that inhibit men from accessing preventive medical care, and careers available to each sex. There is a paucity of research on sex differences in variables that affect SES and cardiovascular health among NHAA and HA.