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Carson, April P.; Rose, Kathryn M.; Catellier, Diane J.; Kaufman, Jay S; .; Wyatt, Sharon B.; Diez-Roux, Ana V.; & Heiss, Gerardo M. (2007). Cumulative Socioeconomic Status across the Life Course and Subclinical Atherosclerosis. Annals of Epidemiology, 17(4), 296-303.


PURPOSE: The purpose of this study is to investigate the relationship between individual-level and neighborhood-level socioeconomic status (SES) across the life course and subclinical atherosclerosis.
METHODS: Participants from the Atherosclerosis Risk in Communities Study (n=12,332) were queried about individual-level SES and residential addresses across the life course. Individual-level measures were scored and summed to obtain a summary score (I-CumSES), whereas residential addresses were geocoded and linked to census data to obtain a summary neighborhood z score (N-CumSES) to evaluate the association of SES with intima-media thickness (IMT) and peripheral arterial disease (PAD).
RESULTS: A 1-SD lower I-CumSES was associated with greater mean IMT in each race-sex group and greater odds of PAD in white men (odds ratio [OR], 1.28; 95% confidence interval [CI], 0.99-1.64), white women (OR, 1.18; 95% CI, 1.02-1.36), and black women (OR, 1.33; 95% CI, 1.00-1.76). Compared with the highest tertile of N-CumSES, the lowest tertile was associated with greater mean IMT among whites, but was not associated with PAD for whites or blacks. When I-CumSES and N-CumSES were considered simultaneously, associations remained for only I-CumSES and were attenuated after adjustment for cardiovascular disease (CVD) risk factors.
CONCLUSIONS: Lower cumulative individual-level SES across the life course was associated with a greater burden of subclinical atherosclerosis, and this association was mediated in part by CVD risk factors.


Reference Type

Journal Article

Year Published


Journal Title

Annals of Epidemiology


Carson, April P.
Rose, Kathryn M.
Catellier, Diane J.
Kaufman, Jay S
Wyatt, Sharon B.
Diez-Roux, Ana V.
Heiss, Gerardo M.