Individual and neighborhood socioeconomic status characteristics and prevalence of metabolic syndrome: the Atherosclerosis Risk in Communities (ARIC) Study.
OBJECTIVE
The objective of this study was to examine the association of individual socioeconomic status (iSES) and neighborhood SES (nSES) on the prevalence of metabolic syndrome (MetS) in the Atherosclerosis Risk in Communities Study (1987-1999).


METHODS
Participants included 2932 black and 9777 white men and women aged 45 to 64 years without diabetes at baseline. Total combined family income for the past 12 months and six census tract socioeconomic measures combined into a composite index were used to quantify iSES and nSES, respectively. Poisson regression was used to assess associations of the joint contribution of iSES and nSES on the MetS, stratified by gender and race and adjusting for multiple covariates. For analyses that included nSES, hierarchical modeling techniques were used.


RESULTS
Using 2005 Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults criteria, MetS was identified in 40% of black women, 30% of white women, 28% of black men, and 35% of white men. Among black and white men, there was no association between MetS and iSES or nSES. In contrast, after adjustment for risk factors, black and white women with low (L)-iSES and medium (M)-iSES were more likely to have MetS than those with high (H)-iSES. Similar but weaker patterns were noted for L-nSES and M-nSES.


CONCLUSIONS
In summary, both iSES and nSES were independently associated with an increased prevalence of MetS among women but not men. Efforts aimed at understanding the causes of these gender differences may offer insight into avenues for reducing the prevalence of the MetS and its chronic disease sequelae.
Chichlowska
Kristal L
KL
Department of Epidemiology, School of Public Health, the University of North Carolina at Chapel Hill, North Carolina, USA. raymon@email.unc.edu
Rose
Kathryn M
KM
Diez-Roux
Ana V
AV
Golden
Sherita H
SH
McNeill
Annie M
AM
Heiss
Gerardo
G
D000428:Alcohol Drinking / Q000453:epidemiology; D050197:Atherosclerosis / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D006801:Humans; D007182:Income; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D009043:Motor Activity; D015995:Prevalence; D044469:Racial Groups / Q000706:statistics & numerical data; D012111:Residence Characteristics; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
Psychosom Med. 2006 May-Jun;68(3):414-20
16738073
Am J Public Health. 1992 Jul;82(7):999-1006
1609919
Diabetologia. 1997 Nov;40(11):1341-9
9389428
Diabetes Care. 2005 Feb;28(2):385-90
15677797
Am J Public Health. 2006 Dec;96(12):2216-21
17077402
Soc Sci Med. 2008 Mar;66(6):1241-55
18177988
Am J Epidemiol. 1989 Apr;129(4):687-702
2646917
Circulation. 2007 Apr 3;115(13):1806-10; discussion 1811
17404171
Diabetes Care. 2007 Jan;30(1):8-13
17192325
Soc Sci Med. 2005 Feb;60(4):737-45
15571892
Am J Epidemiol. 2003 Jan 15;157(2):98-112
12522017
Diabetes Care. 2006 Dec;29(12):2694-700
17130207
Ann Epidemiol. 2007 Oct;17(10):782-90
17697786
Circulation. 2004 Sep 7;110(10):1245-50
15326067
Diabetes Care. 2005 Feb;28(2):409-15
15677801
BMC Public Health. 2008 Feb 18;8:62
18282285
Int J Epidemiol. 2005 Dec;34(6):1266-73
16131515
Soc Sci Med. 2004 Nov;59(10):2139-47
15351479
N Engl J Med. 2001 Jul 12;345(2):99-106
11450679
Eur J Pharmacol. 2008 Apr 7;583(2-3):174-85
18282566
Health Place. 2008 Sep;14(3):453-67
17950024
Hypertension. 2002 Mar 1;39(3):772-6
11897761
Am J Epidemiol. 2003 May 15;157(10):940-3
12746247
Am J Epidemiol. 2008 Feb 15;167(4):419-28
18056924
Diabetologia. 2001 Oct;44(10):1221-31
11692170
JAMA. 2002 Jan 16;287(3):356-9
11790215
J Am Coll Cardiol. 2006 Mar 21;47(6):1093-100
16545636
Psychosom Med. 2004 May-Jun;66(3):316-22
15184689
Am J Public Health. 2007 Feb;97(2):234-6
17194854
Am J Epidemiol. 2002 Sep 1;156(5):471-82
12196317
BMJ. 2003 Jul 12;327(7406):61-2
12855493
Psychol Bull. 1989 Mar;105(2):260-75
2648443
J Psychosom Res. 2006 Nov;61(5):619-27
17084139
Scand J Public Health. 2006;34(3):228-37
16754580
Int J Epidemiol. 2005 Apr;34(2):327-34
15659460
Circulation. 2004 Jan 6;109(1):42-6
14676144
Am J Public Health. 2006 Feb;96(2):325-31
16380567
Obes Rev. 2001 May;2(2):73-86
12119665
J Health Soc Behav. 2001 Sep;42(3):258-76
11668773
J Health Soc Behav. 2005 Jun;46(2):170-86
16028456
Epidemiol Perspect Innov. 2006 Jul 20;3:8
16857050
Diabetes Care. 2002 Nov;25(11):1976-82
12401742
Am J Cardiol. 1986 Mar 1;57(8):538-45
3953436
Annu Rev Public Health. 1997;18:341-78
9143723
J Clin Epidemiol. 1996 Dec;49(12):1441-46
8970495
JAMA. 1996 Jul 24-31;276(4):293-9
8656541
BMJ. 2006 Mar 4;332(7540):521-5
16428252
Ann Epidemiol. 2007 Jan;17(1):19-26
17140811
Ann N Y Acad Sci. 1999;896:210-25
10681899
Am J Clin Nutr. 2004 Apr;79(4):661-8
15051612
Epidemiol Rev. 1988;10:87-121
3066632
Int J Epidemiol. 2003 Jun;32(3):357-66
12777420
Diabetes Care. 2004 Nov;27(11):2707-15
15505009
J Epidemiol Community Health. 2000 Mar;54(3):173-7
10746110
J Affect Disord. 1993 Oct-Nov;29(2-3):77-84
8300980
JAMA. 2001 May 16;285(19):2486-97
11368702
Am J Prev Med. 2007 Aug;33(2):114-20
17673098
J Intern Med. 2001 Aug;250(2):105-20
11489060
J Atheroscler Thromb. 2005;12(6):295-300
16394610
Ann Epidemiol. 2008 Feb;18(2):119-23
18083541
J Hum Hypertens. 1998 Feb;12(2):91-110
9504351
Ann Epidemiol. 2001 Aug;11(6):395-405
11454499
Am J Clin Nutr. 1982 Nov;36(5):936-42
7137077
Prev Med. 1997 Sep-Oct;26(5 Pt 1):734-44
9327484
Lancet. 2005 Apr 16-22;365(9468):1415-28
15836891
Am J Epidemiol. 2002 Dec 1;156(11):1070-7
12446265
Int J Epidemiol. 2004 Apr;33(2):398-407
15082648
Am J Cardiol. 2004 Nov 15;94(10):1249-54
15541239
Diabetes Care. 1999 Dec;22(12):1999-2003
10587833
Ann Epidemiol. 2007 Apr;17(4):320-6
17300958
Am J Epidemiol. 2003 Feb 15;157(4):315-26
12578802
Arch Intern Med. 2003 Feb 24;163(4):427-36
12588201
Int J Epidemiol. 2003 Jun;32(3):381-5
12777423