title: Effect of socioeconomic status on cardio-respiratory fitness: data from a health screening program.
abstract: OBJECTIVE
  Lower socioeconomic status (SES) is associated with reduced cardio-respiratory fitness (CRF) and predicts adverse cardiovascular outcomes. We questioned whether this association remains significant among an apparently healthy population with a presumed higher SES.
  
  
  METHODS
  This cross-sectional study enrolled attendees of a health screening program between September 2002 and November 2010. Linear regression models included the metabolic equivalents achieved during an exercise treadmill stress test as the dependent variable and adjusted for self-reported SES parameters (level of education, occupational status, financial strain and a combined variable), cardiovascular risk factors, as well as to multiple potential confounders.
  
  
  RESULTS
  Data on 8471 individuals (5463 men and 3008 women) with a mean (SD) age of 44 (11) years were collected. We found a statistically significant difference in mean exercise capacity between the categories of SES, especially for the level of education and occupation, when adjusted for age, sex, cardiovascular risk factors, SES variables and multiple confounders.
  
  
  CONCLUSIONS
  Multiple factors affect CRF in apparently healthy screened individuals. When adjusted for those factors, SES correlates with CRF even within a more specific highly educated cohort.
authors.affiliation: aThe Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine bFaculty of Management cNational Institute of Occupational and Environmental Health, Raanana and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel *Hezzy Shmueli and Ori Rogowski should be considered as equal contributors.
authors.forename: Hezzy
authors.initials: H
authors.lastname: Shmueli
authors.forename: Ori
authors.initials: O
authors.lastname: Rogowski
authors.forename: Sharon
authors.initials: S
authors.lastname: Toker
authors.forename: Shmuel
authors.initials: S
authors.lastname: Melamed
authors.forename: Eran
authors.initials: E
authors.lastname: Leshem-Rubinow
authors.forename: Eyal
authors.initials: E
authors.lastname: Ben-Assa
authors.forename: Itzhak
authors.initials: I
authors.lastname: Shapira
authors.forename: Shlomo
authors.initials: S
authors.lastname: Berliner
authors.forename: Arie
authors.initials: A
authors.lastname: Steinvil
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005080:Exercise Test / Q000379:methods; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010809:Physical Fitness / Q000502:physiology*; D012923:Social Class; D012959:Socioeconomic Factors; D055815:Young Adult