Social and behavioral risk marker clustering associated with biological risk factors for coronary heart disease: NHANES 2001-2004.
BACKGROUND
Social and behavioral risk markers (e.g., physical activity, diet, smoking, and socioeconomic position) cluster; however, little is known whether clustering is associated with coronary heart disease (CHD) risk. Objectives were to determine if sociobehavioral clustering is associated with biological CHD risk factors (total cholesterol, HDL cholesterol, systolic blood pressure, body mass index, waist circumference, and diabetes) and whether associations are independent of individual clustering components.


METHODS
Participants included 4,305 males and 4,673 females aged ≥ 20 years from NHANES 2001-2004. Sociobehavioral Risk Marker Index (SRI) included a summary score of physical activity, fruit/vegetable consumption, smoking, and educational attainment. Regression analyses evaluated associations of SRI with aforementioned biological CHD risk factors. Receiver operator curve analyses assessed independent predictive ability of SRI.


RESULTS
Healthful clustering (SRI = 0) was associated with improved biological CHD risk factor levels in 5 of 6 risk factors in females and 2 of 6 risk factors in males. Adding SRI to models containing age, race, and individual SRI components did not improve C-statistics.


CONCLUSIONS
Findings suggest that healthful sociobehavioral risk marker clustering is associated with favorable CHD risk factor levels, particularly in females. These findings should inform social ecological interventions that consider health impacts of addressing social and behavioral risk factors.
Department of Epidemiology, Brown University School of Public Health, Providence, RI 02912, USA.
Nicholas J
NJ
Everage
Center for Statistical Sciences, Brown University School of Public Health, Providence, RI 02912, USA ; Department of Biostatistics, Brown University School of Public Health, Providence, RI 02912, USA.
Crystal D
CD
Linkletter
Department of Epidemiology, Brown University School of Public Health, Providence, RI 02912, USA ; Diabetes Prevention and Control Program, Rhode Island Department of Health, Providence, RI 02912, USA.
Annie
A
Gjelsvik
Department of Epidemiology, Brown University School of Public Health, Providence, RI 02912, USA ; International Health Institute, Brown University School of Public Health, Providence, RI 02912, USA.
Stephen T
ST
McGarvey
Department of Epidemiology, Brown University School of Public Health, Providence, RI 02912, USA ; Center for Population Health & Clinical Epidemiology, Brown University School of Public Health, Providence, RI 02912, USA.
Eric B
EB
Loucks
D000328:Adult; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D003327:Coronary Disease / Q000453:epidemiology* / Q000473:pathology; D004032:Diet; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D012307:Risk Factors; D012907:Smoking; D012923:Social Class
D008076:Cholesterol, HDL; D002784:Cholesterol