Objective and subjective socioeconomic status associated with metabolic syndrome severity among African American adults in Jackson Heart Study

Michelle I Cardel; Yi Guo; Mario Sims; Akilah Dulin; Darci Miller; Xiaofei Chi; Gregory Pavela; Mark D DeBoer; Matthew J Gurka

doi:10.1016/j.psyneuen.2020.104686

Objective and subjective socioeconomic status associated with metabolic syndrome severity among African American adults in Jackson Heart Study

Psychoneuroendocrinology. 2020 Jul:117:104686. doi: 10.1016/j.psyneuen.2020.104686. Epub 2020 Apr 26.

Authors

Michelle I Cardel¹, Yi Guo², Mario Sims³, Akilah Dulin⁴, Darci Miller⁵, Xiaofei Chi⁶, Gregory Pavela⁷, Mark D DeBoer⁸, Matthew J Gurka⁹

Affiliations

¹ Department of Health Outcomes and Biomedical Informatics, University of Florida, PO Box 100177, Gainesville, Florida, 32610-0177, USA. Electronic address: mcardel@ufl.edu.
² Department of Health Outcomes and Biomedical Informatics, University of Florida, PO Box 100177, Gainesville, Florida, 32610-0177, USA. Electronic address: yiguo@ufl.edu.
³ Department of Medicine, University of Mississippi Medical Center, 2500 N. State St., Jackson, Mississippi, 39216, USA. Electronic address: msims2@umc.edu.
⁴ Department of Behavioral and Social Sciences, Brown University School of Public Health, Box G-S121-8, 121 S. Main St., Providence, Rhode Island, 02912, USA. Electronic address: akilah_dulin_keita@brown.edu.
⁵ Department of Health Outcomes and Biomedical Informatics, University of Florida, PO Box 100177, Gainesville, Florida, 32610-0177, USA. Electronic address: dmiller5@ufl.edu.
⁶ Department of Health Outcomes and Biomedical Informatics, University of Florida, PO Box 100177, Gainesville, Florida, 32610-0177, USA. Electronic address: xiaofei.chi@ufl.edu.
⁷ Department of Health Behavior, University of Alabama at Birmingham, 1665 University Blvd., Birmingham, AL 35294, USA. Electronic address: pavela@uab.edu.
⁸ Department of Pediatrics, PO Box 800386, University of Virginia Health System, Charlottesville, Virginia, 22908-0386, USA. Electronic address: MDD5Z@hscmail.mcc.virginia.edu.
⁹ Department of Health Outcomes and Biomedical Informatics, University of Florida, PO Box 100177, Gainesville, Florida, 32610-0177, USA. Electronic address: matthewgurka@ufl.edu.

Abstract

Purpose: To assess independent associations between objective socioeconomic status (OSS) and subjective social status (SSS) with metabolic syndrome (MetS) severity and indicators among African American (AA) adults in the Jackson Heart Study (JHS) at baseline (2000-2004) and eight-year follow-up (2009-2013).

Methods: Participants included 1724 AA adults from the JHS cohort (64.4 % women; mean age 53.4 ± 11.8). Associations of OSS (annual household income and school years completed) and SSS (measured with MacArthur Scales) with sex- and race/ethnic-specific MetS severity Z-score were examined after adjustment for demographics and MetS risk factors (i.e., nutrition, physical activity, smoking status, alcohol consumption, and depressive symptoms) at baseline and eight-year follow-up.

Principal results: Independent of OSS, demographic, psychosocial, and lifestyle factors, individuals with lower US-society SSS had more severe MetS at baseline. A significant interaction existed between sex and US-society SSS such that women with lower perceived social status had more severe MetS severity at baseline, and for every one unit increase in US-society SSS, MetS severity Z-score is estimated to decrease by 0.04. Components of MetS driving the relationship between US-society SSS and MetS severity at baseline were the inverse associations of SSS with glucose levels and the positive associations of SSS with HDL-C. Physical activity was independently associated with MetS severity at baseline, but not at eight-year follow-up.

Major conclusions: Though subjective and objective measures of social status are independently associated with cardiometabolic risk factors and MetS severity among AA adults, SSS may be a stronger predictor of MetS severity than OSS, particularly among women. SSS should be considered in conjunction with OSS when exploring social determinants of cardiometabolic health.

Keywords: African Americans; Cardiometabolic health; Jackson Heart Study; Metabolic syndrome; Social status; Socioeconomic status.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adult
Aged
Black or African American / ethnology*
Female
Humans
Longitudinal Studies
Male
Metabolic Syndrome / ethnology*
Metabolic Syndrome / physiopathology*
Middle Aged
Prognosis
Severity of Illness Index*
Sex Factors
Social Class*
Social Determinants of Health

Abstract

Publication types

MeSH terms

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