SOCIOECONOMIC-STATUS AND HEALTH - HOW EDUCATION, INCOME, AND OCCUPATION CONTRIBUTE TO RISK-FACTORS FOR CARDIOVASCULAR-DISEASE
SOCIOECONOMIC-STATUS AND HEALTH - HOW EDUCATION, INCOME, AND OCCUPATION CONTRIBUTE TO RISK-FACTORS FOR CARDIOVASCULAR-DISEASE
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DOI：
10.2105/ajph.82.6.816
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发表时间：
1992-06-01
影响因子：
12.7
通讯作者：
FORTMANN, SP
中科院分区：
文献类型：
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作者：
WINKLEBY, MA;JATULIS, DE;FORTMANN, SP
背景。社会经济地位（SES）通常通过确定教育程度、收入、职业或这些维度的综合情况来衡量。尽管在流行病学研究中教育是最常用的SES衡量指标，但美国没有研究人员进行过实证分析来量化SES的各个单独维度对疾病风险因素的相对影响。
方法。利用斯坦福五城市项目中2380名参与者的数据（85%为非西班牙裔白人），我们研究了教育、收入和职业对一组心血管疾病风险因素（吸烟、收缩压和舒张压以及总胆固醇和高密度脂蛋白胆固醇）的独立贡献。
结果。这些SES衡量指标与风险因素之间的关系对于教育而言是最强且最一致的，显示出教育水平越低风险越高。在对年龄和调查时间进行调整后，使用允许纳入所有三个SES衡量指标的正向选择模型，教育是唯一与风险因素显著相关的指标（P <.05）。
结论。如果经济或时间因素决定只能选择SES的一个单一参数，并且如果研究假设没有其他要求，高等教育可能是良好健康状况的最佳SES预测指标。
Background. Socioeconomic status (SES) is usually measured by determining education, income, occupation, or a composite of these dimensions. Although education is the most commonly used measure of SES in epidemiological studies, no investigators in the United States have conducted an empirical analysis quantifying the relative impact of each separate dimension of SES on risk factors for disease.Methods. Using data on 2380 participants from the Stanford Five-City Project (85% White, non-His-panic), we examined the independent contribution of education, income, and occupation to a set of cardiovascular disease risk factors (cigarette smoking, systolic and diastolic blood pressure, and total and high-density lipoprotein cholesterol).Results. The relationship between these SES measures and risk factors was strongest and most consistent for education, showing higher risk associated with lower levels of education. Using a forward selection model that allowed for inclusion of all three SES measures after adjustment for age and time of survey, education was the only measure that was significantly associated with the risk factors (P < .05).Conclusion. If economics or time dictate that a single parameter of SES be chosen and if the research hypothesis does not dictate otherwise, higher education may be the best SES predictor of good health.