title: Household income and cardiovascular disease risks in U.S. children and young adults: analyses from NHANES 1999-2008.
abstract: OBJECTIVE
  To assess the cardiovascular risk profile of youths across socioeconomic groups in the U.S.
  
  
  METHODS
  Analysis of 1999-2008 National Health and Nutrition Examination Surveys (NHANES) including 16,085 nonpregnant 6- to 24-year-olds to estimate race/ethnicity-adjusted prevalence of obesity, central obesity, sedentary behaviors, tobacco exposure, elevated systolic blood pressure, glycated hemoglobin, non-HDL cholesterol (non-HDL-C), and high-sensitivity C-reactive protein according to age-group, sex, and poverty-income ratio (PIR) tertiles.
  
  
  RESULTS
  Among boys aged 6-11 years, 19.9% in the lowest PIR tertile were obese and 30.0% were centrally obese compared with 13.2 and 21.6%, respectively, in the highest-income tertile households (P(obesity) < 0.05 and P(central obesity) < 0.01). Boys aged 12-17 years in lowest-income households were more likely than their wealthiest family peers to be obese (20.6 vs. 15.6%, P < 0.05), sedentary (14.8 vs. 9.3%, P < 0.05), and exposed to tobacco (19.0 vs. 6.5%, P < 0.01). Compared with girls aged 12-17 years in highest-income households, lowest-income household girls had higher prevalence of obesity (17.9 vs. 13.1%, P < 0.05), central obesity (41.5 vs. 29.2%, P < 0.01), sedentary behaviors (20.4 vs. 9.4%, P < 0.01), and tobacco exposure (14.1 vs. 5.9%, P < 0.01). Apart from higher prevalence of elevated non-HDL-C among low-income women aged 18-24 years (23.4 vs. 15.8%, P < 0.05), no other cardiovascular disease risk factor prevalence differences were observed between lowest- and highest-income background young adults.
  
  
  CONCLUSIONS
  Independent of race/ethnicity, 6- to 17-year-olds from low-income families have higher prevalence of obesity, central obesity, sedentary behavior, and tobacco exposure. Multifaceted cardiovascular health promotion policies are needed to reduce health disparities between income groups.
authors.affiliation: Rollins School of Public Health, Emory University, Atlanta, GA, USA. mkali@emory.edu
authors.forename: Mohammed K
authors.initials: MK
authors.lastname: Ali
authors.forename: Kai McKeever
authors.initials: KM
authors.lastname: Bullard
authors.forename: Gloria L
authors.initials: GL
authors.lastname: Beckles
authors.forename: Mark R
authors.initials: MR
authors.lastname: Stevens
authors.forename: Lawrence
authors.initials: L
authors.lastname: Barker
authors.forename: K M Venkat
authors.initials: KM
authors.lastname: Narayan
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Imperatore
mesh_terms: D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002648:Child; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D009765:Obesity / Q000453:epidemiology; D011203:Poverty / Q000706:statistics & numerical data; D012307:Risk Factors; D057185:Sedentary Behavior; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D055815:Young Adult