Education, poverty, and stroke incidence in whites and blacks: the NHANES I Epidemiologic Follow-up Study.
The purpose of this study was to test the hypothesis that educational attainment and poverty index are inversely associated with incidence of stroke in blacks and in whites. The NHANES I Epidemiologic Follow-up Study data were analyzed. We analyzed 2953 women and 2661 men with no history of stroke before baseline (1971-1975), using the incidence of stroke through 1992, years of education, and poverty index at baseline. In white men aged 45 to 74, Cox regression models showed an inverse age-adjusted association with education that did not attain statistical significance. In white women, those with 12 or more years of education had significantly lower age-adjusted risk of stroke compared with those with less than 8 years. A test for linear trend was significant when adjusting for age (P = 0.0005). In blacks, stroke risk was significantly lower in those with 8 or more years of education than in those with <8 years in adjusted models. In each group, Cox regression models showed an inverse, graded, age-adjusted association with poverty index that attained statistical significance. After controlling for multiple confounders and risk mediators, the association was diminished and nonsignificant.
Gillum
R F
RF
Centers for Disease Control and Prevention, 3311 Toledo Road, Room 6420, Hyattsville, MD 20782, USA.
Mussolino
Michael E
ME
D001741:Black or African American / Q000706:statistics & numerical data*; D017677:Age Distribution; D000368:Aged; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011203:Poverty; D016016:Proportional Hazards Models; D012307:Risk Factors; D020521:Stroke / Q000208:ethnology* / Q000209:etiology; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*