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Socioeconomic Differences in Cardiometabolic Factors: Social Causation or Health-related Selection? Evidence From the Whitehall II Cohort Study, 1991–2004
Open accessAbstract
In this study, the health-related selection hypothesis (that health predicts social mobility) and the social causation hypothesis (that socioeconomic status influences health) were tested in relation to cardiometabolic factors. The authors screened 8,312 United Kingdom men and women 3 times over 10 years between 1991 and 2004 for waist circumference, body mass index, systolic and diastolic blood pressure, fasting glucose, fasting insulin, serum lipids, C-reactive protein, and interleukin-6; identified participants with the metabolic syndrome; and measured childhood health retrospectively. Health-related selection was examined in 2 ways: 1) childhood health problems as predictors of adult occupational position and 2) adult cardiometabolic factors as predictors of subsequent promotion at work. Social causation was assessed using adult occupational position as a predictor of subsequent change in cardiometabolic factors. Hospitalization during childhood and lower birth weight were associated with lower occupational position (both P's ≤ 0.002). Cardiometabolic factors in adulthood did not consistently predict promotion. In contrast, lower adult occupational position predicted adverse changes in several cardiometabolic factors (waist circumference, body mass index, fasting glucose, and fasting insulin) and an increased risk of new-onset metabolic syndrome (all P's ≤ 0.008). These findings suggest that health-related selection operates at younger ages and that social causation contributes to socioeconomic differences in cardiometabolic health in midlife.
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“Persons with lower socioeconomic status are also at an increased risk of cardiometabolic disease [5, 6]”
From Association between sleep deficiency and cardiometabolic disease: implications for health disparities (2016) · cites this paper as [6]
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Metadata
- Authors
- Elovainio, M., Ferrie, J. E., Singh-Manoux, A., Shipley, M., Batty, G. D., Head, J., Hamer, M., Jokela, M., Virtanen, M., Brunner, E., Marmot, M. G., & Kivimäki, M.
- Affiliations
- University of Helsinki (FI)
- Corresponding author
- Elovainio, Marko
- ORCID
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-08-03
- Volume
- 174
- Issue
- 7
- Pages
- 779-789
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- PMC
- PMC3176829
- OpenAlex
- W2157479690
- Cited by
- 131
- References
- 64
- Citations by year
- 2026: 2 · 2024: 3 · 2023: 6 · 2022: 1 · 2021: 9 · 2020: 12 · 2019: 2 · 2018: 12 · 2017: 15 · 2016: 8 · 2015: 20 · 2014: 12 · 2013: 11 · 2012: 17
- FWCI
- 13.47
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- American Journal of Epidemiology (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- UCL Discovery (University College London) (submittedVersion)
- Työväentutkimus Vuosikirja (submittedVersion)
- STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
- Funders
- Helsingin Yliopisto
- Wellcome Trust
- British Heart Foundation (HL036310, RG/07/008/23674, AG034454)
- Bupa Foundation
- Stroke Association (HL036310, RG/07/008/23674)
- University College London
- European Commission
- European Science Foundation
- Institut National de la Santé et de la Recherche Médicale (U1018)
- Terveyden ja hyvinvoinnin laitos
- Medical Research Council (HL036310, G0902037, RG/07/008/23674)
- National Institute on Aging (5R01 AG13196, R01AG034454, R01AG013196)
- National Heart, Lung, and Blood Institute (RG/07/008/23674, HL036310, 5RO1 HL036310, R01HL036310)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Sociology and Political Science › Intergenerational and Educational Inequality Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- social causation, socioeconomic status, cardiometabolic risk factors, metabolic syndrome, occupational position, child health, hospitalization, birth weight, waist circumference, body mass index, blood pressure, fasting blood glucose, fasting insulin, C-reactive protein, interleukin-6, social mobility, Whitehall II cohort
- MeSH terms
- Adult, Aged, Cardiovascular Diseases, Child, Employment, Female, United Kingdom, Humans, Infant, Low Birth Weight, Infant, Newborn, Lipoproteins, LDL, Male, Middle Aged, Risk Factors, Social Class, Socioeconomic Factors, Cohort Studies, Causality, Logistic Models, Metabolic Syndrome, Health Status Disparities
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