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.
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.
Authors: Xiaoling Wang; Joseph C Poole; Frank A Treiber; Gregory A Harshfield; Coral D Hanevold; Harold Snieder Journal: Circulation Date: 2006-11-27 Impact factor: 29.690
Authors: J Hunter Young; Yen-Pei C Chang; James Dae-Ok Kim; Jean-Paul Chretien; Michael J Klag; Michael A Levine; Christopher B Ruff; Nae-Yuh Wang; Aravinda Chakravarti Journal: PLoS Genet Date: 2005-12-30 Impact factor: 5.917
Authors: Calpurnyia B Roberts; David J Couper; Patricia P Chang; Sherman A James; Wayne D Rosamond; Gerardo Heiss Journal: Am J Epidemiol Date: 2010-08-08 Impact factor: 4.897
Authors: Qianyi Wang; Iván Mejía-Guevara; Pamela M Rist; Stefan Walter; Benjamin D Capistrant; M Maria Glymour Journal: Cerebrovasc Dis Date: 2014-03-25 Impact factor: 2.762
Authors: Anja K Leist; M Maria Glymour; Johan P Mackenbach; Frank J van Lenthe; Mauricio Avendano Journal: Ann Epidemiol Date: 2013-08 Impact factor: 3.797
Authors: Eseosa T Ighodaro; Peter T Nelson; Walter A Kukull; Frederick A Schmitt; Erin L Abner; Allison Caban-Holt; Shoshana H Bardach; Derrick C Hord; Crystal M Glover; Gregory A Jicha; Linda J Van Eldik; Alexander X Byrd; Anita Fernander Journal: J Alzheimers Dis Date: 2017 Impact factor: 4.472
Authors: Dayse Rodrigues de Sousa Andrade; Lidyane V Camelo; Rodrigo Citton P Dos Reis; Itamar S Santos; Antonio Luiz Ribeiro; Luana Giatti; Sandhi Maria Barreto Journal: Int J Public Health Date: 2016-12-02 Impact factor: 3.380
Authors: M Maria Glymour; Emelia J Benjamin; Anna Kosheleva; Paola Gilsanz; Lesley H Curtis; Kristen K Patton Journal: Health Place Date: 2013-02-04 Impact factor: 4.078