title: Racial/ethnic heterogeneity in the socioeconomic patterning of CVD risk factors: in the United States: the multi-ethnic study of atherosclerosis.
abstract: Many studies document racial variation, gender differences, and socioeconomic status (SES) patterning in cardiovascular disease (CVD) risk factors but few studies have investigated heterogeneity in SES differences by race/ethnicity or gender. Using data from the Multi-Ethnic Study of Atherosclerosis (N=6,814) and stratified regression models, we investigated race/ethnic differences in the SES patterning of diabetes, hypertension, smoking, and body mass index (BMI). Inverse socioeconomic gradients in hypertension, diabetes, smoking, and BMI were observed in White and Black women but associations were weaker or absent in Hispanic and Chinese women (except in the case of diabetes for Hispanic women). Even greater heterogeneity in social patterning of risk factors was observed in men. In White men all four risk factors were inversely associated with socioeconomic position, although often associations were only present or were stronger for education than for income. The inverse socioeconomic patterning was much less consistent in men of other races/ethnic groups, and higher SES was associated with higher BMI in non-White men. These findings have implications for understanding the causes of social patterning, for the analysis of SES adjusted race/ethnic differences, and for the targeting of interventions.
authors.affiliation: Center for Integrative Approaches to Health Disparities, Department of Epidemiology, University of Michigan, School of Public Health, Ann Arbor, MI 48109-2029, USA. sdhb@umich.edu
authors.forename: Shawn
authors.initials: S
authors.lastname: Boykin
authors.forename: Ana V
authors.initials: AV
authors.lastname: Diez-Roux
authors.forename: Mercedes
authors.initials: M
authors.lastname: Carnethon
authors.forename: Sandi
authors.initials: S
authors.lastname: Shrager
authors.forename: Hanyu
authors.initials: H
authors.lastname: Ni
authors.forename: Melicia
authors.initials: M
authors.lastname: Whitt-Glover
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000706:statistics & numerical data*; D050197:Atherosclerosis / Q000208:ethnology; D044383:Black People / Q000706:statistics & numerical data*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000208:ethnology*; D003920:Diabetes Mellitus / Q000208:ethnology; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000208:ethnology; D012923:Social Class; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*; D001741:Black or African American