title: Socioeconomic Status and Cardiovascular Risk Control in Adults With Diabetes.
abstract: To examine the association between subjective social status (SSS) and objective social status (OSS) and cardiovascular disease (CVD) risk factors in adults with type 2 diabetes.
  
  
  
  Adult study participants (N = 358) were recruited from 2 primary care settings. The CVD risk factors included hemoglobin A1c (HbA1c), systolic blood pressure and diastolic blood pressure (DBP) and low-density lipoprotein cholesterol (LDL-C). The OSS was assessed by income, education and employment. The SSS was measured using the validated MacArthur Scales of Subjective Social Status to demarcate self-reported perceptions of having the most money, education and respected job using a ladder scale (1 = rung 1, 10 = rung 10). Multiple linear regression was used to examine associations between CVD risk factors and SSC and OSS controlling for age, sex, race or ethnicity, marital status, employment status, income, study site, comorbidity, education and insurance status.
  
  
  
  Fully adjusted models showed that rung 2 (P = 0.029), rung 3 (P = 0.032), rung 8 (P = 0.049) and rung 9 (P = 0.032) of the SSS to be significantly associated with poorer DBP. Annual income ≥ $75,000 was significantly associated with lower LDL-C (P = 0.021). Employment was associated with lower HbA1c (P = 0.036), but higher LDL-C (P = 0.002).
  
  
  
  The SSS and OSSS levels are differentially associated with HbA1c, DBP and LDL-C. Findings provide new information about patients' perspectives of the relationship between social status and diabetes-related outcomes.
authors.affiliation: Department of Medicine, Center for Health Disparities Research, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Tejas
authors.initials: T
authors.lastname: Doshi
authors.affiliation: Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Brittany L
authors.initials: BL
authors.lastname: Smalls
authors.affiliation: Department of Medicine, Center for Health Disparities Research, Medical University of South Carolina, Charleston, South Carolina; Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Joni S
authors.initials: JS
authors.lastname: Williams
authors.affiliation: Department of Medicine, Center for Health Disparities Research, Medical University of South Carolina, Charleston, South Carolina; Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Tamara E
authors.initials: TE
authors.lastname: Wolfman
authors.affiliation: Department of Medicine, Center for Health Disparities Research, Medical University of South Carolina, Charleston, South Carolina; Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina; Health Equity and Rural Outreach Innovation Center (HEROIC), Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, South Carolina. Electronic address: egedel@musc.edu.
authors.forename: Leonard E
authors.initials: LE
authors.lastname: Egede
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012923:Social Class; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Adults; Cardiovascular risk factor control; Diabetes; Objective socioeconomic status; Subjective social status