title: Association of socioeconomic status and CKD among African Americans: the Jackson Heart Study.
abstract: BACKGROUND
  Socioeconomic status (SES) is recognized as a key social environmental factor because it has implications for access to resources that help individuals care for themselves and others. Few studies have examined the association of SES with chronic kidney disease (CKD) in high-risk populations.
  
  
  METHODS
  Single-site longitudinal population-based cohort.
  
  
  METHODS
  Data for this study were drawn from the baseline examination of the Jackson Heart Study. The analytic cohort consisted of 3,430 African American men and women living in the tricounty region of the Jackson, MS, metropolitan area with complete data to determine CKD status.
  
  
  METHODS
  High SES (defined as having a family income at least 3.5 times the poverty level or having at least 1 undergraduate degree).
  
  
  METHODS
  CKD (defined as the presence of albuminuria or decreased estimated glomerular filtration rate [<60 mL/min/1.73 m(2)]). Associations were explored using bivariable analyses and multivariable logistic regression analyses adjusting for CKD and cardiovascular disease risk factors, as well as demographic factors.
  
  
  RESULTS
  The prevalence of CKD in the Jackson Heart Study was 20% (865 of 3,430 participants). Proportions of the Jackson Heart Study cohort with albuminuria and decreased estimated glomerular filtration rate were 12.5% (429 of 3,430 participants) and 10.1% (347 of 3,430 participants), respectively. High SES was associated inversely with CKD. The odds of having CKD were 41% lower for affluent participants than their less affluent counterparts. There were no statistically significant interactions between sex and education or income, although subgroup analysis showed that high income was associated with CKD in men (OR, 0.47; 95% CI, 0.23-0.97), but not women (OR, 0.64; 95% CI, 0.40-1.03).
  
  
  CONCLUSIONS
  Models were estimated using cross-sectional data.
  
  
  CONCLUSIONS
  CKD is associated with SES. Additional research is needed to elucidate the impact of wealth and social contexts in which individuals are embedded and the mediating effects of sociocultural factors.
authors.affiliation: Meharry Medical College, Department of Family and Community Medicine, Nashville, TN 37208, USA . mabruce@mmc.edu
authors.forename: Marino A
authors.initials: MA
authors.lastname: Bruce
authors.forename: Bettina M
authors.initials: BM
authors.lastname: Beech
authors.forename: Errol D
authors.initials: ED
authors.lastname: Crook
authors.forename: Mario
authors.initials: M
authors.lastname: Sims
authors.forename: Sharon B
authors.initials: SB
authors.lastname: Wyatt
authors.forename: Michael F
authors.initials: MF
authors.lastname: Flessner
authors.forename: Herman A
authors.initials: HA
authors.lastname: Taylor
authors.forename: David R
authors.initials: DR
authors.lastname: Williams
authors.forename: Ermeg L
authors.initials: EL
authors.lastname: Akylbekova
authors.forename: T Alp
authors.initials: TA
authors.lastname: Ikizler
mesh_terms: D000328:Adult; D001741:Black or African American / Q000208:ethnology*; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000453:epidemiology; D002908:Chronic Disease; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D018450:Disease Progression; D004522:Educational Status; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology* / Q000208:ethnology* / Q000503:physiopathology; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012727:Sex Characteristics; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000208:ethnology*
references.citation: J Am Soc Nephrol. 2008 Feb;19(2):356-64
references.pmid: 18057219
references.citation: N Engl J Med. 2001 Jul 12;345(2):99-106
references.pmid: 11450679
references.citation: J Natl Med Assoc. 2004 Apr;96(4):486-95
references.pmid: 15101669
references.citation: Diabetes Care. 2008 Jun;31(6):1248-53
references.pmid: 18332154
references.citation: Kidney Int. 2003 Aug;64(2):763-72
references.pmid: 12846781
references.citation: J Natl Black Nurses Assoc. 2008 Jul;19(1):12-8
references.pmid: 18807774
references.citation: Ethn Dis. 2005 Autumn;15(4 Suppl 6):S6-30-37
references.pmid: 16317983
references.citation: Ann N Y Acad Sci. 1999;896:173-88
references.pmid: 10681897
references.citation: Public Health Rep. 2001 Sep-Oct;116(5):404-16
references.pmid: 12042604
references.citation: Hypertension. 2008 Mar;51(3):650-6
references.pmid: 18268140
references.citation: J Natl Black Nurses Assoc. 2007 Dec;18(2):16-23
references.pmid: 18318327
references.citation: Am J Kidney Dis. 2009 Feb;53(2):238-47
references.pmid: 19166799
references.citation: Am J Kidney Dis. 2007 Feb;49(2):217-26
references.pmid: 17261424
references.citation: Am J Epidemiol. 1997 Jul 1;146(1):48-63
references.pmid: 9215223
references.citation: Ethn Dis. 2005 Autumn;15(4 Suppl 6):S6-18-29
references.pmid: 16317982
references.citation: Ethn Dis. 1992 Spring;2(2):126-41
references.pmid: 1467751
references.citation: Am J Public Health. 2001 Nov;91(11):1783-9
references.pmid: 11684601
references.citation: Int J Epidemiol. 2001 Aug;30(4):668-77
references.pmid: 11511581
references.citation: J Am Soc Nephrol. 2002 Sep;13(9):2363-70
references.pmid: 12191981
references.citation: J Am Soc Nephrol. 2008 Jul;19(7):1261-70
references.pmid: 18525000
references.citation: Psychosom Med. 2001 Mar-Apr;63(2):267-72
references.pmid: 11292274
references.citation: Kidney Int Suppl. 2005 Aug;(97):S137-40
references.pmid: 16014092
references.citation: BMJ. 1996 Jan 13;312(7023):69-70
references.pmid: 8555922
references.citation: Public Health Rep. 2001 Sep-Oct;116(5):419-23
references.pmid: 12042606
references.citation: J Natl Med Assoc. 2007 Apr;99(4):349-56
references.pmid: 17444423
references.citation: J Am Soc Nephrol. 2003 Nov;14(11):2902-7
references.pmid: 14569100
references.citation: JAMA. 2003 May 21;289(19):2560-72
references.pmid: 12748199
references.citation: Diabetes Care. 2002 Nov;25(11):1976-82
references.pmid: 12401742
references.citation: Soc Sci Med. 2007 Aug;65(4):809-21
references.pmid: 17499411
references.citation: J Investig Med. 2009 Apr;57(4):583-9
references.pmid: 19240646
references.citation: Ethn Dis. 2005 Autumn;15(4 Suppl 6):S6-4-17
references.pmid: 16320381
references.citation: Ann Intern Med. 2007 Apr 3;146(7):493-501
references.pmid: 17404351
references.citation: Am J Kidney Dis. 2005 Aug;46(2):203-13
references.pmid: 16112038
references.citation: J Am Coll Health. 2000 May;48(6):243-6
references.pmid: 10863867
references.citation: Ethn Dis. 2005 Autumn;15(4 Suppl 6):S6-38-48
references.pmid: 16317984
references.citation: Ann N Y Acad Sci. 1999;896:396-8
references.pmid: 10681933
references.citation: Am J Epidemiol. 1988 Aug;128(2):370-80
references.pmid: 3394703
references.citation: Rev Epidemiol Sante Publique. 2007 Feb;55(1):13-21
references.pmid: 17320330
references.citation: Am J Epidemiol. 2002 Apr 15;155(8):700-9
references.pmid: 11943687
references.citation: Circulation. 2002 Aug 6;106(6):703-10
references.pmid: 12163431
references.citation: J Natl Med Assoc. 2007 Oct;99(10):1152-8
references.pmid: 17987919
references.citation: Am J Med Sci. 2004 Sep;328(3):131-44
references.pmid: 15367870