Evaluating the evidence for models of life course socioeconomic factors and cardiovascular outcomes: a systematic review

Pollitt, Ricardo A.; Rose, Kathryn M.; Kaufman, Jay S.

doi:10.1186/1471-2458-5-7

Cited by 433 publications

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“…More specifically, several studies conducted in adult population have provided some solid proof of an inverse relationship between the clustering of certain CVD risk factors and socioeconomic level (Tyroler, 1999;Baigi et al, 2002;Pollitt et al, 2005). However, in children, there is less evidence for the existence of such a relationship, thus requiring wider investigation.…”

Section: Introductionmentioning

confidence: 99%

Relations between obesity and hypertension: preliminary data from a cross-sectional study in primary schoolchildren: The children study

et al. 2006

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Objective: To record the prevalence of overweight, obesity and hypertension in primary schoolchildren living in one of the poorest regions in Europe and furthermore to identify certain behavioural, lifestyle and physiological parameters associated with body mass index (BMI) and blood pressure (BP). Design: Cross-sectional study. Setting: Nineteen primary schools within the county of Ioannina, Greece. Subjects and methods: Demographic, dietary and physical activity data as well as anthropometrical, BP and cardiorespiratory fitness measurements were obtained from a representative sample of 312 school children (153 boys and 159 girls) attending 5th grade. Inclusion of subjects in the study was voluntary. One-way analysis of variance and multiple linear regression analysis were mainly applied for the evaluation of the tested hypotheses. Results: The prevalence of overweight and obesity was 29.4 and 11.8% for boys and 39.0 and 7.5% for girls. The prevalence of systolic and diastolic hypertension was 28.1 and 7.8% for boys and 26.4 and 17.0% for girls. Furthermore, BMI and BP (systolic and diastolic) were positively related to frequency of fast food meals (rho: þ 0.28, P ¼ 0.033, rho: þ 1.09, P ¼ 0.03 and rho: þ 0.86, P ¼ 0.014, respectively) but negatively to leisure time physical activity (rho: À5.55, P ¼ 0.005, rho: À3.32 Â 10 À2 , Po0.001 and rho: À2.08 Â 10 À2 , Po0.001, respectively). Conclusions: The current study revealed an increased prevalence of overweight, obesity and hypertension among schoolchildren in Ioannina, indicating the need for early preventive measures in one of the less privileged regions of Europe.

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Section: Introductionmentioning

confidence: 99%

Relations between obesity and hypertension: preliminary data from a cross-sectional study in primary schoolchildren: The children study

et al. 2006

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“…The strength of the associations varies in relation to the degree and chronicity of exposure to adverse conditions and is most robust for adult cardiovascular disease and mortality (reviewed in refs. [9][10][11].…”

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confidence: 99%

Rigor, vigor, and the study of health disparities

Adler

Bush²,

Pantell

2012

Proc. Natl. Acad. Sci. U.S.A.

104

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Health disparities research spans multiple fields and methods and documents strong links between social disadvantage and poor health. Associations between socioeconomic status (SES) and health are often taken as evidence for the causal impact of SES on health, but alternative explanations, including the impact of health on SES, are plausible. Studies showing the influence of parents' SES on their children's health provide evidence for a causal pathway from SES to health, but have limitations. Health disparities researchers face tradeoffs between "rigor" and "vigor" in designing studies that demonstrate how social disadvantage becomes biologically embedded and results in poorer health. Rigorous designs aim to maximize precision in the measurement of SES and health outcomes through methods that provide the greatest control over temporal ordering and causal direction. To achieve precision, many studies use a single SES predictor and single disease. However, doing so oversimplifies the multifaceted, entwined nature of social disadvantage and may overestimate the impact of that one variable and underestimate the true impact of social disadvantage on health. In addition, SES effects on overall health and functioning are likely to be greater than effects on any one disease. Vigorous designs aim to capture this complexity and maximize ecological validity through more complete assessment of social disadvantage and health status, but may provide less-compelling evidence of causality. Newer approaches to both measurement and analysis may enable enhanced vigor as well as rigor. Incorporating both rigor and vigor into studies will provide a fuller understanding of the causes of health disparities.methodology | social determinants of health | cumulative risk G ood health and longevity are unequally distributed in populations. Although some unavoidable variations in health emanate from individual differences in vulnerability to disease, others are linked to membership in socially disadvantaged groups. The latter are unjust and have been the focus of considerable research and policy (1). Research on these health disparities has demonstrated consistent graded associations between various components of socioeconomic status (SES) and a wide range of health indicators; at each step up the social ladder, whether indexed by higher income, education, and/or occupational level, rates of morbidity and mortality decrease (2). The prevailing understanding of this relationship is that SES is a "fundamental cause" of health status (3), which operates through physical and/or psychosocial resources that are more readily available as SES increases, and hardships and adverse exposures that are more intense and frequent as SES decreases.Evidence for the SES-health gradient comes primarily from cross-sectional data linking contemporaneous measures of SES in adulthood with prevalence of disease, poor health, or mortality. Smaller literatures have established associations between socioeconomic conditions in childhood and childhood health, and betwe...

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“…This may be due to the lower physical activity level of the individuals with aboveknee amputation than the individuals with below-knee amputation. Earlier studies (Pollitt et al, 2005) have proved the statement; however, in the present study, there is no way to examine the above statement because the data on physical activity level is not available for the individuals with locomotor disability. On the contrary, 'locomotor index' (a measurement of functional outcome) of individuals with LEA shows that a large proportion (42.42%) of individuals with above-knee amputation is dependent on other individuals to perform daily activities, compared to only 26.32% of the individuals with below-knee amputation.…”

Section: Discussionmentioning

confidence: 65%

“…Grundy et al (1999) emphasized physical inactivity as one of the leading factors of CVD. This was supported by Oldridge and Stump (2004) and Pollitt et al (2005) and they proved that low physical activity level have a fatal effect, which often leads to enhance the risk of developing CVD in the general population. Physically disabled individuals are particularly vulnerable to the problem, especially the locomotor-disabled person, who generally have a very low physical activity level owing to their impairedness.…”

Section: Introductionmentioning

confidence: 76%

Validity of an alternative anthropometric trait as cardiovascular diseases risk factor: example from individuals with traumatic lower extremity amputation

Mozumdar

2006

Eur J Clin Nutr

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Background: Published studies reveal that individuals with lower extremity amputation are vulnerable to cardiovascular diseases (CVD) because of poor physical activity level. Many cardiovascular risk assessment studies have utilized anthropometric traits (primarily body mass index and waist circumference) as cardiovascular risk factor. However, some studies emphasized the technical limitations of measuring waist circumference for studying cardiovascular risk, and so it is difficult to obtain correct measurement from the individuals with lower extremity amputation. Objectives: The objectives of the present article are to study the prevalence of CVD risk factors among the individuals with traumatic lower extremity amputation and to test the validity of upper arm circumference (UAC) as an alternative anthropometric measurement for screening the CVD risk condition. Subjects and setting: Anthropometric data and other cardiovascular traits data have been collected from unilateral traumatic lower extremity amputated adult males (n ¼ 85) residing in Calcutta and adjoining areas. Results: Results show higher prevalence of cardiovascular risk factor among individuals with above-knee amputation than below-knee amputation. The receiver operating characteristics curve analysis shows significant ability of upper arm circumference to diagnose cardiovascular risk condition. The cutoff value of UAC426.6 cm show maximum sensitivity and specificity for the diagnosis of cardiovascular risk condition. Although, binomial tests for equality of proportion does not show any significant difference, however, agreement statistics reveal better diagnostic ability of cutoff value of UAC than the existing cutoff value of waist circumference. Conclusions: Therefore, UAC provides a better assessment of cardiovascular risk condition than does waist circumference especially for individuals with lower extremity amputation.

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Evaluating the evidence for models of life course socioeconomic factors and cardiovascular outcomes: a systematic review

Cited by 433 publications

References 91 publications

Relations between obesity and hypertension: preliminary data from a cross-sectional study in primary schoolchildren: The children study

Relations between obesity and hypertension: preliminary data from a cross-sectional study in primary schoolchildren: The children study

Rigor, vigor, and the study of health disparities

Validity of an alternative anthropometric trait as cardiovascular diseases risk factor: example from individuals with traumatic lower extremity amputation

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