Role of allostatic load and health behaviours in explaining socioeconomic disparities in mortality: a structural equation modelling approach

Kim, Gyu Ri; Jee, Sun Ha; Pikhart, Hynek

doi:10.1136/jech-2017-209131

Cited by 17 publications

(5 citation statements)

References 39 publications

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“…Neighborhoods inhabited by lower SES populations have been shown to exhibit higher availability of calorie-dense food choices and associated food cues [53,54], and such environmental forces have been associated with the rising trends in overconsumption and associated obesity over recent decades [55,56]. SES also serves as a more general proxy of the quality of the surrounding environment, capturing factors including stress exposure [57] and lower opportunities for physical activity [58], as well as poorer access to nutritional foods [59]. Our results are therefore consistent with a differential susceptibility model whereby individual variations in dopamine-mediated openness to the environment affect the likelihood of unfavorable responses (i.e.…”

Section: Discussionmentioning

confidence: 99%

Predicted DRD4 prefrontal gene expression moderates snack intake and stress perception in response to the environment in adolescents

et al. 2020

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Body weight is substantially determined by eating behaviors, which are themselves driven by biological factors interacting with the environment. Previous studies in young children suggest that genetic influences on dopamine function may confer differential susceptibility to the environment in such a way that increases behavioral obesity risk in a lower socioeconomic status (SES) environment but decreases it in a higher SES environment. We aimed to test if this pattern of effect could also be observed in adolescence, another critical period for development in brain and behavior, using a novel measure of predicted expression of the dopamine receptor 4 (DRD4) gene in prefrontal cortex. In a sample of 76 adolescents (37 boys and 39 girls from Baltimore, Maryland/US, aged 14-18y), we estimated individual levels of DRD4 gene expression (PredDRD4) in prefrontal cortex from individual genomic data using PrediXcan, and tested interactions with a composite SES score derived from their annual household income, maternal education, food insecurity, perceived resource availability, and receipt of public assistance. Primary outcomes were snack intake during a multiitem ad libitum meal test, and food-related impulsivity assessed using a food-adapted go/ no-go task. A linear regression model adjusted for sex, BMI z-score, and genetic ethnicity demonstrated a PredDRD4 by composite SES score interaction for snack intake (p = 0.009), such that adolescents who had lower PredDRD4 levels exhibited greater snack

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Section: Discussionmentioning

confidence: 99%

Predicted DRD4 prefrontal gene expression moderates snack intake and stress perception in response to the environment in adolescents

et al. 2020

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“…It was an efficient way to summarise common variation in four conventional SEP measures while also using all the available information under the assumption that responses were missing at random. Latent SEP variables have been previously used to explore socioeconomic inequalities in health [21, 22] and oral health [23, 24]. The composite SEP measure was suitable to explore the interplay of ethnicity and SEP with edentulousness, but alternative measures might be needed to explore their interplay with toothache.…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic inequalities in adult oral health across different ethnic groups in England

Delgado‐Angulo

Mangal

Bernabé

2019

Health Qual Life Outcomes

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Background Ethnic inequalities in oral health among British adults remain largely unexplored. This study explored the role of socioeconomic position (SEP) in explaining ethnic inequalities in oral health; and the consistency of socioeconomic inequalities in oral health across ethnic groups. Methods Data from 45,599 adults, aged 16 years and over, who participated in the Health Survey for England were pooled across 5 years. The seven ethnic groups included were White British, Irish, Black Caribbean, Indian, Pakistani, Bangladeshi and Chinese. Edentulousness and toothache were the outcome measures. A composite measure of SEP was developed based on education, social class, income and economic activity using confirmatory factor analysis. Ethnic inequalities in oral health were assessed in logistic regression adjusting for sex, age, survey year and SEP. Results Indian (OR: 0.55, 95%CI: 0.40–0.76), Pakistani (0.56, 0.38–0.83), Bangladeshi (0.35, 0.23–0.52) and Chinese (0.41, 0.25–0.66) were less likely to be edentulous than White British after controlling for SEP. Irish (1.22, 1.06–1.39) and Caribbean (1.37, 1.19–1.58) were more likely and Bangladeshi (0.83, 0.69–0.99) were less likely to have toothache than White British after controlling for SEP. Socioeconomic inequalities in edentulousness were consistently found across almost all ethnic groups while socioeconomic inequalities in toothache were found among White British and Irish only. Conclusion This study shows that the role of SEP in explaining ethnic inequalities in oral health depended on the outcome being investigated. Socioeconomic inequalities in oral health among minority ethnic groups did not consistently reflect the patterns found in White British. Electronic supplementary material The online version of this article (10.1186/s12955-019-1156-3) contains supplementary material, which is available to authorized users.

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“…The repetitive exposure to stressors leading to AL is the potential pathway of social disparities in cardiometabolic health. Several previous studies17 30 31 suggest that AL may be an important mediator of the relationship between social determinants and cardiometabolic health. Further research is needed to better understand the mechanisms through which social determinants influence cardiometabolic health.…”

Section: Discussionmentioning

confidence: 98%

Comparison of social gradient in cardiometabolic health in Czechia and Venezuela: a cross-sectional study

et al. 2023

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ObjectivesThis study compared the relationships of social determinants with cardiometabolic risk in different socioeconomic contexts: sociopolitically unstable Venezuela (VE) and stable Czechia (CZ).Design: cross-sectional analysis involving two population-based studies.SettingBrno, Czechia and 23 cities of Venezuela.Participants25–64 years old subjects from CZ (2013–2014, n=1579, 56% females) and VE (2014–2017, n=1652, 70% females).Main outcome measuresThe composite cardiometabolic risk score (CMRS) (scaled 0–8) was calculated using eight biomarkers (body mass index, waist circumference, blood glucose, systolic and diastolic blood pressure, total and high-density lipoprotein-cholesterol, triglycerides). Social characteristics included education in both countries, income in CZ and a composite measure of social position (SP) in VE. Sex stratified ordinal regression examined the social gradient in having less favourable CMRS.ResultsIn CZ, men and women with low education and women with low income had higher odds of higher CMRS compared with those with high education and income with OR 1.45 (95% CI 1.01 to 2.21), 2.29 (95% CI 1.62 to 3.24) and 1.69 (95% CI 1.23 to 2.35). In VE, women with low education and low SP had higher odds to have higher CMRS OR 1.47 (95% CI 1.09 to 1.97) and 1.51 (95% CI 1.16 to 1.97), while men with low education and low SP had lower odds to have higher CMRS OR 0.64 (95% CI 0.41 to 1.00) and 0.61 (95% CI 0.40 to 0.97), compared with those with high education and high SP. Independently of age, sex and socioeconomic characteristics, Venezuelans had higher odds to have higher CMRS than Czechs (OR 2.70; 95% CI 2.37 to 3.08).ConclusionsThe results suggest that the associations of socioeconomic status indices and cardiometabolic risk differed between CZ and VE, likely reflecting differences in the social environment among countries. Further research is needed to confirm and quantify these differences.

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Role of allostatic load and health behaviours in explaining socioeconomic disparities in mortality: a structural equation modelling approach

Cited by 17 publications

References 39 publications

Predicted DRD4 prefrontal gene expression moderates snack intake and stress perception in response to the environment in adolescents

Predicted DRD4 prefrontal gene expression moderates snack intake and stress perception in response to the environment in adolescents

Socioeconomic inequalities in adult oral health across different ethnic groups in England

Comparison of social gradient in cardiometabolic health in Czechia and Venezuela: a cross-sectional study

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