Cumulative Socioeconomic Status Research Articles

Relationship between socioeconomic status and cognitive ability among Chinese older adults: the moderating role of social support

BackgroundUnderstanding the causes and pathways of cognitive decline among older populations is of great importance in China. This study aims to examine whether the discrepancy in socioeconomic status (SES) makes a difference to the cognitive ability among Chinese older adults, and to disentangle the moderating role of different types of social support in the process in which SES influences cognition.MethodsWe utilized a nationally representative sample from the 2018 Chinese Longitudinal Healthy Longevity Survey. A cumulative SES score was constructed to measure the combined effect of different socioeconomic statuses on the cognitive ability of the elderly. We further examined the moderating role of two types of social support, including emotional support, and financial support. Hierarchical regression analysis was applied to test the direct effect of SES on cognitive ability, and to investigate the moderating role of social support on the association of the SES with the dependent variables.ResultsThe results showed that the higher SES of older adults was significantly associated with better cognitive ability (β = 0.52, p < 0.001) after controlling for age, sex, marital status, living region, Hukou, health insurance, lifestyle factors, and physical health status. Emotional support and financial support were moderated the relationship between SES score and cognitive ability.ConclusionOur results reveal the importance of considering social support in buffering the effects of SES and the associated cognitive ability for aging populations. It highlights the importance of narrowing the socioeconomic gap among the elderly. Policymakers should consider promoting social support to improve the cognitive ability among older adults.

Cumulative socioeconomic status and incident type 2 diabetes among African American adults from the Jackson heart study

BackgroundThe cumulative socioeconomic status (SES) model posits that childhood and adult experiences accumulate to influence disease risk. While individual SES indicators such as education and income are independently associated with incident type 2 diabetes (T2D), the association of cumulative SES and incident T2D is unclear, especially in African American adults. MethodsWe utilized cohort data of African American participants (n = 3681, mean age 52.6 years) enrolled in the Jackson Heart Study from 2000 to 2013 free of T2D or cardiovascular disease at baseline (2000–2004). Cumulative SES scores at baseline were derived using six SES indicators (education, wealth, income, occupation, employment status, and mother's education) categorized as low, middle, and high. Incident T2D was defined at exam 2 (2005–2008) or exam 3 (2009–2013) based on fasting glucose ≥126 mg/dL, HbA1c ≥ 6.5, reported diabetic medication use, or self-reported physician diagnosis. Proportional hazards regression, allowing for interval censoring, was used to estimate the association between cumulative SES and incident T2D (hazard ratio(HR), 95% confidence interval (CI)) after adjustment for covariates. Sex and age differences were tested using interaction terms. ResultsThere were 544 incident T2D cases. The association between low (versus high) cumulative SES and incident T2D was not significant (HR 1.04 [95% CI 0.85, 1.28]) and did not differ by sex (p value for interaction>0.05). However, there were differences by (age p value for interaction = 0.0052 for middle-aged adults and 0.0186 for older adults). Low (versus high) cumulative SES was associated a greater hazard of incident T2D among those 20–46 years (HR 1.12 [95% CI 1.03, 1.21]), 47–59 years (HR 1.25 [95% CI 1.06, 1.47]) and those 60–93 years (HR 1.39 [95% CI 1.09, 1.78]) after adjustment for sex and family history of diabetes. Associations attenuated after adding behavioral and lifestyle risk factors. ConclusionThe association of low cumulative SES and incident T2D differed by age, which may suggest interventionist should consider impacts of SES on T2D by age.

Socioeconomic status, positive experiences, and allostatic load.

Socioeconomic disparities in physiological well-being may be a pathway to the poorer health outcomes observed in those of lower socioeconomic status (SES). The present research examined greater frequency of positive life experiences (POS) as a route through which greater cumulative SES (CSES) may be linked to lower allostatic load (AL), a multisystem index of physiological dysregulation, and assessed whether the association between POS and AL varies along the socioeconomic spectrum. These associations were examined using data from the Midlife Development in the United States Biomarker Project (N = 2,096). Analyses included tests of whether positive experiences mediated the CSES-AL association, whether CSES moderated associations of positive experiences and AL, and whether CSES moderated positive experience mediation of the CSES-AL association (moderated mediation). The observed association between CSES and AL was weakly mediated by POS. CSES moderated the POS-AL association, such that POS was associated with AL only at lower levels of CSES. The moderated mediation analysis showed that POS mediated the association between CSES and AL only at lower levels of CSES. The results suggest complexity in associations between cumulative socioeconomic advantage, positive life events, and physiological well-being. Positive life events may play a stronger role in physiological health in those of lower socioeconomic advantage, as one of multiple pathways through which lower SES is linked to poor health. Given the modifiability of access to, and frequency of, positive life events, the potential role of positive experiences in lessening health disparities warrants further study. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The association between socioeconomic status and use of potentially inappropriate medications in older adults.

Potentially inappropriate medication (PIM) use is an important public health problem, particularly among older adults who may need multiple pharmacologic therapies for various chronic conditions. As socioeconomic status (SES) affects the quality of healthcare that individuals receive, SES may be associated with the use of PIM in older adults. This study aimed to determine whether low SES is associated with increased use of PIM. We studied 4927 participants (aged 66-90 years) who were on at least one medication at visit five (2011-2013) of the Atherosclerosis Risk in Communities Study. We created a cumulative SES score categorized as high (7-9), middle (3-6), and low (0-2) based on education, income, and area deprivation index. We use multivariable logistic regression to examine the associations between SES and use of two or more PIM for older adults, defined by the 2019 Beers Criteria. A total of 31.0% and 6.9% of the participants used one or more PIM and two or more PIM, respectively. After adjusting for demographic characteristics and insurance type, low cumulative SES score was associated with significantly greater use of two or more PIM (odds ratio [OR]=1.83 [95% confidence interval (CI) 1.18-2.86]), as was middle cumulative SES score (OR=1.40 [95% CI 1.06-1.83]), compared to high cumulative SES score. The results remained significant after further adjusting for comorbidities and medication burden for low cumulative SES score (OR=1.66 [95%CI 1.02-2.71]). We found that lower SES was associated with greater use of PIM among older adults independent of their medication burden and comorbidities, suggesting socioeconomic disparities in quality of medication management. Focused efforts targeting older adults with low SES to reduce PIM use may be needed to prevent adverse drug events.

Abstract 14008: Socioeconomic Status and Prediction of Incident Heart Failure in the Atherosclerosis Risk in Communities (ARIC) Study

Introduction: Socioeconomic status (SES) is a potent risk factor for heart failure (HF), but current HF prediction models do not incorporate data on SES. It is not known if the performance of HF risk prediction algorithms differs by SES, and how including SES in risk models impacts risk prediction. Methods: We performed an analysis of participants without HF at Visit 1 (1987-89) of the ARIC study. SES was assessed by household income, educational attainment, Area Deprivation Index, and as a combined cumulative SES score that included all three measures. Incident hospitalizations and deaths related to HF were assessed through 12/31/2019. We compared risk discrimination (c-statistic) of the established ARIC HF risk score across SES categories, and assessed calibration within SES strata by comparing observed versus predicted risk. We examined changes in risk discrimination, net reclassification and calibration (calculating the Hosmer-Lemeshow statistic for the latter) with adding SES to the ARIC HF risk score. Results: We studied 14,468 individuals; 54% were women, 26% were Black adults and 22% had low cumulative SES. There were 3,568 HF events over 33 years of follow-up. The c-statistic of the ARIC HF risk score was lower in those with low versus high cumulative SES (0.726 vs 0.765). There were differences in the ARIC HF risk score’s calibration by SES, with lower predicted than observed HF risk in those with low SES in all quintiles of predicted risk (Figure). Calibration improved with adding SES to the risk model (change in Hosmer-Lemeshow 127.6 to 98.3), especially in those with low SES (Figure). Adding SES to the model modestly improved risk discrimination (change in c-statistic 0.767 to 0.771; p&lt;0.001) and changed net reclassification (0.05 [95% CI 0.02-0.08]). Conclusions: HF prediction algorithms underestimate HF risk in those with low SES. Systematic assessment and incorporation of SES data may enhance HF risk prediction in socioeconomically diverse populations.

Socioeconomic vulnerabilities and food intake in European children: The Feel4Diabetes Study

ObjectivesSocioeconomic inequalities create substantial burdens influencing children's health status and diet quality. The aim of this study was to investigate the association between cumulative socioeconomic vulnerabilities and differences in the food intake of children. MethodsThis was a cross-sectional analysis of baseline data from 12 041 European parent–child dyads (children were 5–12 y of age with 49% boys) enrolled in the Feel4 Diabetes study. Parents completed standardized questionnaires to record details on socioeconomic status (SES), demographic, and children's frequency of food and beverage intake. Vulnerable groups were defined as children whose parents had <12 y of education, were unemployed, or reported difficult household income security. A cumulative SES vulnerability score (range 0–4) was created by adding the number of vulnerabilities a child was exposed to. ResultsLogistic regression showed that children with the highest SES vulnerability score were less likely to consume water (odds ratio [OR], 0.42; 95% confidence interval [CI], 0.30–0.59), fresh fruit (OR, 0.66; 95% CI, 0.56–0.78) and vegetables (OR, 0.67; 95% CI, 0.56–0.81) daily in comparison with those with no SES vulnerabilities, whereas they were more likely to consume canned fruit (OR, 2.30; 95% CI, 1.64-3.24), fruit juice (OR, 1.42; 95% CI, 1.14-1.77), soft drinks (regular: OR, 4.85; 95% CI, 3.85-6.10; diet: OR, 4.81; 95% CI, 3.28-7.06), and salty snacks/fast food (OR, 3.92; 95% CI, 3.05-5.04) daily, after adjusting for children's age, sex, country, and weight status. ConclusionThe findings of this study highlighted that an unhealthy dietary profile was characteristic of European children in families with a high number of SES vulnerabilities. School-based public health programs promoting healthy eating in children should prioritize families with cumulative SES vulnerabilities.

Abstract P229: The Association Of Cumulative Socioeconomic Status And Incident Type 2 Diabetes Among African Americans: The Jackson Heart Study

Background: The burden of type 2 diabetes (T2D) is disproportionately higher among racial and ethnic minorities, particularly African American individuals who have low socioeconomic status (SES). According to the cumulative SES life-course model, stressful experiences in early life and later life can accumulate to influence disease risk. Yet, little is known about the association between cumulative SES, or the combined effects of different SES phenotypes (i.e., education, wealth, income, etc.), over the life course and development of T2D. Objective: To estimate the association of cumulative SES and incident T2D among men and women without T2D and cardiovascular disease at baseline (2000-2004) from the Jackson Heart Study (JHS) (n=3078). Methods: Using cohort data from JHS (mean age 52.8 years; 1969 women, 1109 men), we derived standardized cumulative SES scores at baseline, conceptualized using 6 SES indicators (e.g. educational attainment, wealth, income, occupation, employment status and mother’s education) and dichotomized the score as high SES (median and above - referent) and low SES (below the median). Incident T2D was defined at exam 2 (2005-2008) or exam 3 (2009-2013) based on a fasting glucose ≥126 mg/dL, or HbA1c ≥ 6.5, or those who had been on diabetic medication 2 weeks prior to these visits, or those who reported a physician diagnosis. Interval censoring proportional hazards regression was used to estimate the association between cumulative SES and incident T2D using hazard ratios (HR, 95% confidence interval-CI), where time-to-event was approximated as the interval between the first visit and the visit in which T2D was ascertained. Sex differences were evaluated using interaction terms and descriptive statistics. The fully-adjusted model included baseline covariates: age, waist circumference, health behaviors, and family history of diabetes. Results: There were 544 total incident T2D cases and 65% (351) of cases were characterized as having low SES. The dichotomized cumulative score was associated with incident T2D ( p &lt;0.05) in unadjusted chi square analyses. In the fully-adjusted models, low (vs. high) cumulative SES and the standardized score were marginally associated with incident T2D (HR 1.14; 95% CI (0.95, 1.38) and HR 0.99; 95% CI (0.90, 1.08), respectively). There were no significant sex differences in the association between cumulative SES and incident T2D. Conclusion: Low cumulative SES was not significantly associated with development of T2D when adjusting for potential confounders. Future work should consider examination of adverse experiences related to low SES and other environmental factors such as built environment and neighborhood SES.

Abstract P178: Methylation Sites Associated With Cumulative Socioeconomic Status And Body Mass Index Among African American Adults From The Atherosclerosis Risk In Communities Study

Background: Obesity increases the risk of multiple morbidities and is patterned by socioeconomic status (SES). Lower SES is associated with greater burden of obesity, especially among African American adults. Epigenetic research has provided novel insights into human biology and health; however, few studies have examined whether epigenetic loci mediate the association between SES and obesity. Objective: We sought to determine the union of epigenetic sites associated with cumulative SES and body mass index (BMI) among African American adults from the Atherosclerosis Risk in Communities (ARIC) study, and to examine differences by sex. Hypothesis: Several Cytosine-phosphate-guanine (CpG) sites will be associated with both cumulative SES and BMI, which will provide suggestive evidence of epigenetic mechanisms mediating the association between SES and obesity. Also, sex differences will be detected. Methods: Methylation data from venous blood of 2,684 African American adults (1702 women, 982 men) in the ARIC study (mean age 56.61) was collected from either visit 2 (1990-1992) or visit 3 (1993-1995) using the Illumina HumanMethylation 450k array. For each participant, we created a cumulative SES score comprised of education, income, and occupation from visit 1 (1987-1989). Each SES indicator had 3 categories, which were given a score of 0 (low), 0.5 (medium), or 1 (high), then all SES indicator scores were summed (mean 1.47, SD 0.76, range: 0-3). BMI values (mean 30.12, SD 6.26, range 14.68-62.35) from the same visit as the methylation typing, were then inverse rank normalized. Linear regression analyses were used to test the association of cumulative SES scores and the association of BMI residuals with CpG sites, respectively. Analyses were stratified by sex and combined using inverse variance fixed-effect meta-analysis. The final model adjusted for age, age 2 , alcohol use, smoking, genetic principal components and time between visits. Statistical significance was determined as p &lt;2X10 -7 . Results: Among men and women combined, 3,843 CpG sites were associated with cumulative SES and 212 CpG sites were associated with BMI. Thirty (n=30) CpG sites were statistically significant for both cumulative SES and BMI. Of the 30 sites, 15 sites were previously identified in epigenetic studies of obesity/BMI, and 11 sites were previously identified for other cardiometabolic traits. Sites were statistically more significant among women. Conclusion: Our findings suggest shared patterns of epigenetic variation between SES and BMI and differences by sex. As a follow up, we will replicate our study findings in other cohort studies and test the hypothesis that the effect of SES on obesity is mediated through methylation. Indeed, such findings could reveal how SES gets “under the skin” to influence obesity. Such knowledge could help us better identify therapeutic targets for intervention.

Abstract P136: The Association Between Socioeconomic Status And Use Of Potentially Inappropriate Medications In Older Adults

Introduction: The use of potentially inappropriate medications (PIM), defined as medications for which the risk of adverse events outweighs the expected benefits, increases the risk of hospitalization, adverse drug events, and mortality in older adults. As socioeconomic status (SES) influences health care quality, the purpose of this study is to investigate whether PIM use differs by SES in older adults. Hypothesis: We hypothesized that low SES was independently associated with increased use of PIM. Methods: We studied participants (aged 66-90 years) who were on at least one medication at visit 5 (2011-2013) of the Atherosclerosis Risk in Communities (ARIC) Study. We created a cumulative SES score, based on neighborhood SES (area deprivation index [ADI]) as well as individual SES (education and income). Because PIM for older adults defined by the 2019 Beers Criteria was extremely common (31% of the population), we focused on the use of two or more PIM. We used multivariable logistic regression to examine the associations between SES and PIM use ≥2. Results: Among 4927 participants (mean age of 75.6 (SD 5.1) years, 19.6% Black, and 57.8% female), 6.9% were on two or more PIMs. Overall, compared with individuals with high cumulative SES, those with lower SES had higher odds of PIM use in a dose-dependent manner (odds ratio [OR]: 1.40 [95% confidence interval (CI), 1.06-1.83] for middle cumulative SES; 1.83 [1.18-2.86] for low cumulative SES, Table ), adjusting for demographics and insurance type. For each SES component, low neighborhood SES (i.e., high ADI) and low education was significantly associated with higher odds of PIM use, but not income. Conclusions: We found that lower SES was associated with greater use of PIM among older adults, suggesting that there exist disparities in quality of care by SES. Focused efforts targeting older adults with low SES to reduce PIM use may be needed to prevent adverse outcomes.

Abstract 13852: Socioeconomic Status is Associated With Recurrent Cardiovascular Disease Events in People With Prevalent Cardiovascular Disease

Introduction: While low socioeconomic status (SES) is an established risk factor for incident cardiovascular disease (CVD), there is scarce data regarding the association between SES and recurrent CVD events. Hypothesis: SES measures are associated with recurrent CVD events and mortality among those with prevalent CVD. Methods: We examined 3,031 individuals in the ARIC Study who developed CVD (either myocardial infarction [MI], heart failure [HF] or stroke) from the baseline visit (1987-1989) through 2013 to allow 5 years follow-up for recurrent CVD. SES was defined using baseline measures of income, education and area deprivation index (ADI), modeled individually and combined in a cumulative SES score. We used adjusted Cox proportional hazard regression to evaluate the associations of SES with composite and individual outcomes of first recurrent CVD and mortality. Results: Median age was 69 years, 49% were female, 29% Black. Over a median follow up of 4.6 years, 2,033 participants (67%) had a recurrent CVD event, and 2,202 (73%) died. Relative to the highest income group, being in the lowest income group was associated with higher risk for recurrent CVD (HR 1.27; 95% CI: 1.07-1.51) and mortality (HR 1.32; 95% CI: 1.12-1.56) ( Table ). Similarly, less than high school education was associated with increased risk of recurrent CVD (HR 1.25; 95% CI: 1.04-1.51) and mortality (HR 1.21; 95% CI: 1.01-1.45). No significant outcome associations were seen for ADI. Low cumulative SES was associated with approximately 20% higher risk of recurrent CVD, total mortality and the composite of recurrent CVD and mortality. Similar patterns were seen for individual subtypes of CVD, with the strongest SES-mortality associations for MI and stroke. Conclusions: In the high-risk group of individuals with existing CVD, low SES was linked to greater likelihood of recurrent CVD events and death. SES should be a focus in the design of secondary prevention efforts to improve outcomes in CVD.

Disparities on Baseline Performance Using Neurocognitive and Oculomotor Clinical Measures of Concussion

Background: Given the high participation of Black/African American individuals in high school sports, especially high-risk sports for concussion, it is important to note if racial and socioeconomic status (SES) differences exist in baseline performance on clinical measures of concussion. Purpose: To explore the association between race and SES on baseline concussion assessments of neurocognitive performance and oculomotor function in adolescent athletes. Study Design: Cohort study (Diagnosis); Level of evidence, 3. Methods: A total of 564 high school athletes (mean ± SD age, 15.33 ± 1.1 years) completed the baseline Immediate Post-Concussion Assessment and Cognitive Test and King-Devick (KD) battery before the start of their competitive season. Race was defined as either White/non-Hispanic or Black/African American. SES status was determined by whether the individual’s participating high school was a Title I or non–Title I school. A series of multivariable linear regression analyses were conducted to evaluate the association of computerized neurocognitive test scores (verbal memory, visual memory, motor processing speed, and reaction time), symptom severity scores, and KD scores by race and SES. Results: White/non-Hispanic individuals performed significantly better than Black/African American individuals on verbal memory (P < .01), visual memory (P < .01), visual motor processing speed (P < .01), and reaction time (P < .01) and had a lower symptom score (P < .01). Regarding SES, individuals from non–Title I schools performed better on visual memory (P = .05) and reaction time (P = .02) than individuals from Title I schools. Examination of cumulative KD test reading time revealed that there was no association between race on baseline reading times (P = .12). There was a significant association between cumulative reading time and SES (P = .02). Individuals from non–Title I schools performed significantly faster than individuals from Title I schools on KD test time. Conclusion: Overall, race and SES influence neurocognitive and oculomotor concussion baseline performance in high school athletes. These findings add to the growing literature on the influence of race and SES on neurocognitive and oculomotor function baseline concussion assessments; they highlight the necessity for individualized concussion baseline measurements or race-specific normative reference values.

Socioeconomic status, health-related behaviours, and death among older people: the Concord health and aging in men project prospective cohort study

BackgroundConflicting evidence exists regarding the association of socioeconomic status (SES) with mortality among older people and little is known about the mechanisms underlying this association. We investigated the association of SES with mortality among older Australian men. We also investigated potential mediating effects of health-related behaviours in SES-mortality associations.MethodsWe used data from a prospective population-based cohort (the Concord Health and Aging in Men Project), in Sydney, Australia. The main outcomes were all-cause and cause-specific mortality. Educational attainment, occupational position, source of income, housing tenure, and a cumulative SES score were assessed at baseline. Longitudinally assessed alcohol consumption, smoking, physical activity, and body mass index were investigated as potential mediators. Associations were quantified using Cox regression.ResultsWe evaluated 1527 men (mean age: 77.4 ± 5.5 years). During a mean follow-up time of 9.0 years, 783 deaths occurred. For deaths from all causes, the adjusted hazard ratio (HR) for the lowest tertile of cumulative SES score versus the highest tertile was 1.44 (95% CI 1.21 to 1.70); the corresponding sub-HRs were 1.35 (0.96 to 1.89) for cardiovascular disease (CVD) mortality; 1.58 (1.15 to 2.18) for cancer mortality, and 1.86 (1.36 to 2.56) for non-CVD, non-cancer mortality. SES-mortality associations were attenuated by 11–25% after adjustment for mediating health-related behaviours.ConclusionLow SES is associated with increased mortality in older Australian men and health-related behaviours accounted for less than one-fourth of these associations. Further research is needed to fully understand the mechanisms underlying SES inequalities in mortality among older people.

Life-course socioeconomic status and lung function in adulthood: a study in the EPIPorto cohort

ObjectiveThis study aims to investigate the association of life-course socioeconomic status (SES) with lung function during adulthood, by exploring the influence of life-course social mobility and of cumulative exposure to...

Cumulative socioeconomic status risk and observations of parent depression: Are there associations with child outcomes?

Parental depression (Goodman et al., 2011) and low socioeconomic status (SES) are important risk factors for child maladjustment. Further, depression and low SES are linked; low SES adults are more likely to experience depression. Whereas studies commonly covary out noise associated with SES variability, research on the association of SES with child outcomes after controlling for parental depression is limited. This study aimed to extend the literature by observing parent depressive affect and evaluating the relationship between cumulative SES risk and child problems as well as whether child gender moderates this association using multigroup nested model comparisons. Findings suggested that cumulative SES risk status explained significant variance in child- and parent-reported internalizing problems and parent-reported externalizing problems after accounting for observed parent depressive affect. Of importance, child gender moderated 2 of these significant findings (i.e., child-reported internalizing and parent-reported externalizing behaviors), such that girls, but not boys, were at higher risk of problems in the context of high cumulative SES risk. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Repetitive negative thinking, meaning in life, and serum cytokine levels in pregnant women: varying associations by socioeconomic status.

Elevated proinflammatory cytokines and decreased antiinflammatory cytokines are important in the context of perinatal health, and immune dysregulation has been found among perinatal women with low socioeconomic status (SES). Data examining psychological factors that may contribute to cytokines in pregnancy are lacking. Of importance, these associations may be most evident among women with low SES. This study examined the moderating role of SES on associations among presence of meaning in life and repetitive negative thinking with cytokine levels among 67 pregnant women. A cumulative SES index was calculated using income, education, perceived social class, and receipt of governmental support. Measures included the Perseverative Thinking Questionnaire, Meaning in Life Questionnaire, and serum interleukin (IL)-6 as well as IL-4. Using PROCESS, moderation analyses showed significant interactions between psychological factors and SES in predicting serum cytokines. In the context of high SES only, greater repetitive negative thinking was associated with higher levels of the proinflammatory cytokine IL-6 (p = 0.056) while greater meaning in life was associated with higher levels of the antiinflammatory cytokine IL-4 (p = 0.02). Findings from this study suggest that the benefits of these psychological factors on cytokine levels may be most readily observable among women with greater economic stability. Identifying psychological factors that positively contribute to biological functioning in women experiencing heightened economic distress will be crucial in addressing SES-related disparities in perinatal health.

Neighborhood socioeconomic status and adherence to dietary recommendations among Finnish adults: A retrospective follow-up study.

Neighborhood socioeconomic status (SES) is associated with dietary habits among the residents, but few studies have examined this association separately among long-term residents and movers. We calculated cumulative neighborhood SES score weighted by residential time in each address over 6 years for non-movers (n = 7704) and movers (n = 8818) using national grid database. Increase in average neighborhood SES was associated with higher adherence to dietary recommendations in both groups. Among the movers, an upward trajectory from low to high neighborhood SES was also associated with better adherence. Our findings suggest high SES areas might offer healthier food environments than low SES areas.

Psychological factors moderate the link between SES and inflammatory markers in pregnant women

Elevated pro-inflammatory cytokines and decreased anti-inflammatory cytokines are linked with adverse perinatal health outcomes. One key contributor to inflammation is socioeconomic status (SES). Data examining psychological factors that modify the relationship between SES and inflammation in pregnancy are lacking. This study examined the roles of repetitive negative thinking (RNT) and presence of meaning in life on the SES-inflammation link among 67 pregnant women. A cumulative SES index defined as income, education, perceived social class, and receipt of governmental support was calculated. Measures included the Perseverative Thinking Questionnaire, Meaning in Life Questionnaire, IL-6, and IL-4. Relationships between SES with IL-6 (p = 0.08) and IL-4 (p = 0.47) were not significant. Using PROCESS, moderation analyses showed significant interactions between SES and psychological factors on inflammation. Greater SES was associated with (a) lower IL-6 levels among women reporting low RNT (p = 0.03) and (b) higher IL-4 levels among women reporting high presence of meaning in life (p = 0.02). These effects only emerged in women with high SES. Findings remained after adjustment for race, pre-pregnancy body mass index, exercise, gestational age at visit, and medical conditions. In sum, in pregnant women, greater SES was beneficial for inflammatory markers among women exhibiting enhanced psychological functioning. Future examinations should identify targets of psychological intervention that mitigate the effects of financial stress on inflammation in women with low SES.

Socio-economic trajectories and cardiovascular disease mortality in older people: the English Longitudinal Study of Ageing.

BackgroundSocio-economic status from early life has been linked to cardiovascular disease risk, but the impact of life-course socio-economic trajectories, as well as the mechanisms underlying social inequalities in cardiovascular disease risk, is uncertain.ObjectivesWe assessed the role of behavioural, psychosocial and physiological (including inflammatory) factors in the association between life-course socio-economic status and cardiovascular disease mortality in older adults.MethodsParticipants were 7846 individuals (44% women) from the English Longitudinal Study of Ageing, a representative study of individuals aged ≥ 50 years, established in 2002–03. Comprising four indicators of socio-economic status (father’s social class, own education, occupational position and wealth), we computed an index of socio-economic trajectory and a lifetime cumulative socio-economic score. Behavioural (smoking, physical activity, alcohol consumption, body mass index) and psychosocial (social relations, loneliness) factors, physiological (blood pressure, total cholesterol, triglycerides) and inflammatory markers (C-reactive protein, fibrinogen), measured repeatedly over time, were potential explanatory variables. Cardiovascular disease mortality was ascertained by linkage of study members to a national mortality register. Mediation was calculated using the traditional ‘change-in-estimate method’ and alternative approaches such as counterfactual mediation modelling could not be applied in this context.ResultsDuring the 8.4-year follow-up, 1301 study members died (438 from cardiovascular disease). A stable low-social-class trajectory was associated with around double the risk of cardiovascular disease mortality (hazard ratio; 95% confidence interval: 1.94, 1.37; 2.75) compared with a stable high social class across the life course. Individuals in the lowest relative to the highest life-course cumulative socio-economic status group were also more than twice as likely to die of cardiovascular disease (2.57, 1.81; 3.65). Behavioural factors and inflammatory markers contributed most to explaining this gradient, whereas the role of psychosocial and other physiological risk factors was modest.ConclusionsIn a population-based cohort of older individuals living in England, we provide evidence that disadvantage across the life course is linked to cardiovascular mortality. That behavioural factors and inflammatory markers partially explain this gradient may provide insights into the potential for intervention.

Gender Differences in the Association between Childhood Socioeconomic Status and Cognitive Function in Later Life

Objectives. This study was aimed to explore the gender differences in the association between childhood socioeconomic status (SES) and cognitive function in later life.Methods. Using a nationally representative sample from the Health and Retirement Study, 5,544 females and 3,863 males were analyzed separately. Growth curve models were used to examine memory status and change in memory from 1998 to 2010.Results. The results showed that SES disadvantage in childhood was associated with lower memory at baseline controlling for adult SES and other covariates. In addition, cumulated disadvantage in SES was associated with poor memory in both genders. Statistically, the impact of cumulative SES on memory function at baseline was significantly different by gender.Discussion. These findings suggest that childhood SES has long-term effects on cognitive function among both men and women, and cumulative SES from childhood to adulthood may be more important for men than women with respect to their memory performance.

Socioeconomic Status Across the Life Course and Cognitive Function Among Older Adults: An Examination of the Latency, Pathways, and Accumulation Hypotheses.

This study investigated the relationship between life course socioeconomic status (SES) and cognitive function among older adults in the United States over a 12-year observation period. The mediation of adult SES on the association between childhood SES and cognition was examined, along with the relationship between cumulative SES and cognition. Using a nationally representative sample from the Health and Retirement Study, cognitive status and change in cognition from 1998 to 2010 were examined using growth curve models. The results showed that cognitive function varied within-persons and between-persons. SES disadvantage in childhood was associated with lower cognitive function at baseline. Adult SES mediated the relationship between childhood SES and cognitive function. Persons with higher cumulative SES demonstrated an advantage in cognitive function. Childhood SES and adult SES both had relationships with cognitive status and, to a lesser degree, change in cognition in later life.