|Title||Lifecourse social conditions and racial disparities in incidence of first stroke.|
|Publication Type||Journal Article|
|Year of Publication||2008|
|Authors||M. Glymour, M, Avendano, M, Haas, SA, Berkman, LF|
|Journal||Annals of Epidemiology|
|Keywords||African Americans, Aged, Aged, 80 and over, Cardiovascular Diseases, Ethnic Groups, European Continental Ancestry Group, Female, Health Status Disparities, Humans, Incidence, Interviews as Topic, Life Style, Longitudinal Studies, Male, Middle Aged, Models, Statistical, Risk Factors, Social Environment, Socioeconomic factors, Stroke, United States|
PURPOSE: Some previous studies found excess stroke rates among black subjects persisted after adjustment for socioeconomic status (SES), fueling speculation regarding racially patterned genetic predispositions to stroke. Previous research was hampered by incomplete SES assessments, without measures of childhood conditions or adult wealth. We assess the role of lifecourse SES in explaining stroke risk and stroke disparities.
METHODS: Health and Retirement Study participants age 50+ (n = 20,661) were followed on average 9.9 years for self- or proxy-reported first stroke (2175 events). Childhood social conditions (southern state of birth, parental SES, self-reported fair/poor childhood health, and attained height), adult SES (education, income, wealth, and occupational status) and traditional cardiovascular risk factors were used to predict first stroke onset using Cox proportional hazards models.
RESULTS: Black subjects had a 48% greater risk of first stroke incidence than whites (95% confidence interval, 1.33-1.65). Childhood conditions predicted stroke risk in both blacks and whites, independently of adult SES. Adjustment for both childhood social conditions and adult SES measures attenuated racial differences to marginal significance (hazard ratio, 1.13; 95% CI, 1.00-1.28).
CONCLUSIONS: Childhood social conditions predict stroke risk in black and White American adults. Additional adjustment for adult SES, in particular wealth, nearly eliminated the disparity in stroke risk between black and white subjects.
|Endnote Keywords|| |
Stroke/Socioeconomic Factors/Life Cycle/African-Americans
|Endnote ID|| |
|PubMed Central ID||PMC2796851|
|Grant List||R01 AG023399 / AG / NIA NIH HHS / United States |
R01 AG023399-03 / AG / NIA NIH HHS / United States
AG023399 / AG / NIA NIH HHS / United States