title: The impact of lifecourse socioeconomic position on cardiovascular disease events in African Americans: the Jackson Heart Study.
abstract: BACKGROUND
  Few studies have examined the impact of lifecourse socioeconomic position (SEP) on cardiovascular disease (CVD) risk among African Americans.
  
  
  RESULTS
  We used data from the Jackson Heart Study (JHS) to examine the associations of multiple measures of lifecourse SEP with CVD events in a large cohort of African Americans. During a median of 7.2-year follow-up, 362 new or recurrent CVD events occurred in a sample of 5301 participants aged 21 to 94. Childhood SEP was assessed by using mother's education, parental home ownership, and childhood amenities. Adult SEP was assessed by using education, income, wealth, and public assistance. Adult SEP was more consistently associated with CVD risk in women than in men: age-adjusted hazard ratios for low versus high income (95% CIs), 2.46 (1.19 to 5.09) in women and 1.50 (0.87 to 2.58) in men, P for interaction=0.1244, and hazard ratio for low versus high wealth, 2.14 (1.39 to 3.29) in women and 1.06 (0.62 to 1.81) in men, P for interaction=0.0224. After simultaneous adjustment for all adult SEP measures, wealth remained a significant predictor of CVD events in women (HR=1.73 [1.04, 2.85] for low versus high). Education and public assistance were less consistently associated with CVD. Adult SEP was a stronger predictor of CVD events in younger than in older participants (HR for high versus low summary adult SEP score 3.28 [1.43, 7.53] for participants ≤50 years, and 1.90 (1.36 to 2.66) for participants >50 years, P for interaction 0.0846). Childhood SEP was not associated with CVD risk in women or men.
  
  
  CONCLUSIONS
  Adult SEP is an important predictor of CVD events in African American women and in younger African Americans. Childhood SEP was not associated with CVD events in this population.
authors.affiliation: Metabolic, Cardiovascular and Inflammatory Disease Genomics Branch, National Human Genome Research Institute (NHGRI), National Institutes of Health, Bethesda, MD (S.Y.G.).
authors.forename: Samson Y
authors.initials: SY
authors.lastname: Gebreab
authors.affiliation: Michigan Center for Integrative Approaches to Health Disparities (CIAHD), Drexel University, Philadelphia, PA (A.V.D.R.) School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.).
authors.forename: Ana V
authors.initials: AV
authors.lastname: Diez Roux
authors.affiliation: Department of Epidemiology, School of Public Health, University of Michigan, Jackson, MS (A.B.B.).
authors.forename: Allison B
authors.initials: AB
authors.lastname: Brenner
authors.affiliation: School of Medicine, University of Mississippi Medical Center, Jackson, MS (D.M.A.H., M.S., M.E.G., S.B.W.).
authors.forename: DeMarc A
authors.initials: DA
authors.lastname: Hickson
authors.affiliation: School of Medicine, University of Mississippi Medical Center, Jackson, MS (D.M.A.H., M.S., M.E.G., S.B.W.).
authors.forename: Mario
authors.initials: M
authors.lastname: Sims
authors.affiliation: Indian Institute of Technology, Gandhinagar, India (M.S.).
authors.forename: Malavika
authors.initials: M
authors.lastname: Subramanyam
authors.affiliation: School of Medicine, University of Mississippi Medical Center, Jackson, MS (D.M.A.H., M.S., M.E.G., S.B.W.).
authors.forename: Michael E
authors.initials: ME
authors.lastname: Griswold
authors.affiliation: School of Medicine, University of Mississippi Medical Center, Jackson, MS (D.M.A.H., M.S., M.E.G., S.B.W.) School of Nursing, University of Mississippi Medical Center, Jackson, MS (S.B.W.).
authors.forename: Sharon B
authors.initials: SB
authors.lastname: Wyatt
authors.affiliation: Department of Epidemiology, Rollins School ofPublic Health, Emory University, Atlanta, GA (S.A.J.).
authors.forename: Sherman A
authors.initials: SA
authors.lastname: James
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000208:ethnology* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008922:Mississippi / Q000453:epidemiology; D012307:Risk Factors; D012737:Sex Factors; D012923:Social Class; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: African Americans; adult SEP; cardiovascular disease events; childhood SEP; epidemiology; lifecourse; socioeconomic position