Cumulative socioeconomic disadvantage and cardiovascular disease mortality in the Alameda County Study 1965 to 2000

Abstract

PurposeSocioeconomic disadvantage is often evaluated at single points in the adult life course in health research. Social mobility models suggest that socioeconomic patterns may also influence disease risk. This study examines cumulative socioeconomic disadvantage (CSD) in relation to cardiovascular disease mortality (CVDM). MethodsData were from the Alameda County Study (n = 2530). The CSD indices included father's education, the respondent's education, and either average or latent variable trajectory models of adulthood household income (1965–1994). Proportional hazards models were used to assess the associations between CSD and CVDM. ResultsThe CSD measures were not associated with CVDM in men. Among women, the magnitude of the association between CSD and CVDM was greater for the income trajectory (hazard ratio3 vs 0 = 4.73, 95% confidence interval = 2.20–10.18) compared with the average income (hazard ratio3 vs 0 = 3.78, 95% confidence interval = 1.67–8.53) CSD measure. ConclusionsMeasures of CSD that incorporate patterning of resources over the life course were associated with CVDM for women but not men. Patterning of available socioeconomic resources may differentially influence chronic disease risk and mortality by gender, and future work should continue to investigate how greater patterns variability in available resources influences health outcomes.