Socioeconomic status, John Henryism and blood pressure among African-Americans in the Jackson Heart Study
Socioeconomic status, John Henryism and blood pressure among African-Americans in the Jackson Heart Study
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DOI：
10.1016/j.socscimed.2013.06.016
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发表时间：
2013-09-01
影响因子：
5.4
通讯作者：
Wyatt, Sharon B.
中科院分区：
文献类型：
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作者：
Subramanyam, Malavika A.;James, Sherman A.;Wyatt, Sharon B.
约翰·亨利主义意味着一种强烈的行为倾向，即努力、积极地应对困难的社会和经济压力。这种行为倾向是通过12项约翰·亨利主义积极应对量表（JHAC）来衡量的。约翰·亨利假说预测，众所周知的反社会经济地位（SES）与血压之间的关联在JHAC得分高的人中比在JHAC得分低的人中更强。我们使用杰克逊心脏研究的基线数据在一个大型非裔美国人队列中验证了这一假设。与以往的研究不同，我们使用了多个经济地位指标：收入、教育、职业、童年经济地位和累积经济地位。由于该假设与仍在劳动力中的成年人最为相关，因此我们排除了退休参与者，产生了3978个样本量。校正年龄、John Henryism、SES和John Henryism-SES交互项的高血压性别泊松回归模型适合检验相关性。对每个SES指标分别进行模型拟合。我们发现了一些证据，表明约翰·亨利主义改变了收入与男性高血压之间的关系：在约翰·亨利主义得分高的男性中，低收入与高血压患病率较高相关（低收入与高收入的患病率比（PR）为1.12），但在约翰·亨利主义得分低的男性中，高血压患病率较低（PR为0.85，乘积相互作用的单侧P值）
John Henryism connotes a strong behavioral predisposition to engage in effortful, active coping with difficult social and economic stressors. This behavioral predisposition is measured by the 12 item John Henryism Scale for Active Coping (JHAC). The John Henry hypothesis predicts that the well-known inverse socioeconomic status (SES)-blood pressure association will be stronger among persons who score high rather than low on the JHAC. We tested this hypothesis in a large African American cohort using baseline data from the Jackson Heart Study. Unlike previous studies, we used multiple indicators of SES: income, education, occupation, childhood SES and cumulative SES. Because the hypothesis is most relevant for adults still in the labor force, we excluded retired participants, yielding a sample size of 3978. Gender-specific Poisson regression models for hypertension adjusting for age, John Henryism, SES, and a John Henryism-SES interaction term, were fit to examine associations. Separate models were fit for each SES indicator. We found some evidence that John Henryism modified the association between income and hypertension in men: low income was associated with higher prevalence of hypertension in men who scored high on John Henryism (prevalence ratio (PR) for low vs. high income tertile 1.12), but with lower hypertension prevalence among men who scored low on John Henryism (PR 0.85, one sided P value for multiplicative interaction