title: Childhood Socioeconomic Circumstances, Inflammation, and Hemostasis Among Midlife Women: Study of Women's Health Across the Nation.
abstract: Childhood socioeconomic status (SES) is related to risk for cardiovascular disease in adulthood, perhaps, in part, due to associations with inflammatory and hemostasis processes. We tested the hypotheses that childhood SES is related to C-reactive protein (CRP), fibrinogen, factor VIIc, and plasminogen activator inhibitor-1 (PAI-1) in midlife women and that the associations are mediated by adult SES and/or adult body mass index (BMI).
  
  
  
  Using data from the prospective Study of Women's Health Across the Nation, we classified 1067 black and white women into 3 multidimensional childhood SES groups based on latent class analysis. Biological measures were assessed across 7 years along with covariates and mediators and analyzed by mixed regression models, followed by tests for mediation.
  
  
  
  Compared with women raised in high SES families, those from the lowest SES families had higher levels of CRP (b [standard error] = 0.37 [0.11]), PAI-1 (b = 0.23 [0.07]) factor VIIc (b = 0.05 [0.02]), and fibrinogen (b = 11.06 [4.89]), after adjustment for ethnicity, site, age, ratings of health between ages 11 and 18 years, visit, smoking status, menopausal status, stroke or heart attack, medications, and hormone use. Introduction of adult SES and BMI into the models reduced the childhood SES associations to nonsignificance for all four measures. Indirect mediation was apparent for adult education and BMI for CRP, and BMI for PAI-1.
  
  
  
  Women raised in lower SES families had elevated markers of inflammation and hemostasis, in part, due to elevated BMI and education in adulthood.
authors.affiliation: From the Departments of Psychiatry and Department of Psychology (Matthews, Thurston), Epidemiology (Matthews, Bromberger, Thurston), and Neurological Surgery (Chang), University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Epidemiology (Karvonen-Gutierrez), University of Michigan School of Public Health, Ann Arbor, Michigan; Department of Psychiatry and Department of Preventive Medicine (Kravitz), Rush University Medical Center, Chicago, Illinois; and Department of Sociology (Montez), Syracuse University, Syracuse, New York.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Matthews
authors.forename: Yuefang
authors.initials: Y
authors.lastname: Chang
authors.forename: Joyce T
authors.initials: JT
authors.lastname: Bromberger
authors.forename: Carrie A
authors.initials: CA
authors.lastname: Karvonen-Gutierrez
authors.forename: Howard M
authors.initials: HM
authors.lastname: Kravitz
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Thurston
authors.forename: Jennifer Karas
authors.initials: JK
authors.lastname: Montez
mesh_terms: D000069586:Adult Survivors of Child Adverse Events; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D005167:Factor VII / Q000378:metabolism*; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D005500:Follow-Up Studies; D006487:Hemostasis; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000453:epidemiology; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D012923:Social Class; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D016387:Women's Health / Q000706:statistics & numerical data*
chemical_list: D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human; D005167:Factor VII; D005340:Fibrinogen; D002097:C-Reactive Protein