The influence of socioeconomic factors on cardiovascular disease risk factors in the context of economic devel pment in the Samoan archipelago
The influence of socioeconomic factors on cardiovascular disease risk factors in the context of economic devel pment in the Samoan archipelago
复制标题
DOI：
10.1016/j.socscimed.2006.06.023
复制
发表时间：
2006-11-01
影响因子：
5.4
通讯作者：
McGarvey, Stephen T.
中科院分区：
文献类型：
--
作者：
Ezeamama, Amara E.;Viali, Satupaitea;McGarvey, Stephen T.
在经济发展的早期，社会经济地位（SES）和心血管疾病（CVD）风险因素之间存在正相关，而在最发达的市场经济社会中，存在负相关。本报告的目的是描述的横截面和纵向协会之间的指标SES和心血管疾病的危险因素在一个遗传同质的人口萨摩亚在不同的经济发展水平。在基线1289参与者25-58岁，并在4年的后续行动，963名参与者进行了研究，在经济欠发达的萨摩亚和较发达的美属萨摩亚。SES在基线时通过教育、职业和物质生活方式进行评估。在基线和4年随访时测量心血管疾病危险因素、肥胖、2型糖尿病和高血压，并计算随访时任何心血管疾病危险因素的指数。性别和地点（萨摩亚和美属萨摩亚）特定的多变量逻辑回归模型被用来检验在调整年龄和其他SES指标后，基线SES和CVD风险因素之间的关系。此外，基于所有三个SES指标，为每个个体构建有序SES指数，并在多变量模型中用于估计两个位置的SES指数上CVD风险因素的预测概率。在使用特定SES指标和CVD风险因素结果的模型中，以及使用顺序SES指数和CVD风险因素预测概率的模型中，我们检测到高SES模式与以下因素相关：（1）欠发达萨摩亚CVD风险因素的几率升高，（2）较发达美属萨摩亚CVD风险因素的几率降低。我们的结论是，在萨摩亚和直接协会在美属萨摩亚的SES和心血管疾病的风险因素之间的反向关联的模式是由于整个萨摩亚的异质性，在特定的暴露于社会经济发展过程和个人的心血管疾病的风险因素的自然历史。研究结果表明，必须根据经济发展水平、风险因素暴露的社会经济背景以及年龄、性别和教育水平等个人特征，制定萨摩亚非传染性疾病干预措施。(c)2006爱思唯尔有限公司保留所有权利。
Early in economic development there are positive associations between socioeconomic status (SES) and cardiovascular disease (CVD) risk factors, and in the most developed market economy societies there are negative associations. The purpose of this report is to describe cross-sectional and longitudinal associations between indicators of SES and CVD risk factors in a genetically homogenous population of Samoans at different levels of economic development.At baseline 1289 participants 25-58 yrs, and at 4-year follow-up, 963 participants were studied in less economically developed Samoa and in more developed American Samoa. SES was assessed by education, occupation, and material lifestyle at baseline. The CVD risk factors, obesity, type-2 diabetes and hypertension were measured at baseline and 4-year follow-up, and an index of any incident CVD risk factor at follow-up was calculated. Sex and location (Samoa and American Samoa) specific multivariable logistic regression models were used to test for relationships between SES and CVD risk factors at baseline after adjustment for age and the other SES indicators.In addition an ordinal SES index was constructed for each individual based on all three SES indicators, and used in a multivariable model to estimate the predicted probability of CVD risk factors across the SES index for the two locations. In both the models using specific SES measures and CVD risk factor outcomes, and the models using the ordinal SES index and predicted probabilities of CVD risk factors, we detected a pattern of high SES associated with: (1) elevated odds of CVD risk factors in less developed Samoa, and (2) decreased odds of CVD risk factors in more developed American Samoa. We conclude that the pattern of inverse associations between SES and CVD risk factors in Samoa and direct associations in American Samoa is attributable to the heterogeneity across the Samoas in specific exposures to social processes of economic development and the natural history of individual CVD risk factors. The findings suggest that interventions on non-communicable diseases in the Samoas must be devised based on the level of economic development, the socio-economic context of risk factor exposures, and individual characteristics such as age, sex and education level. (c) 2006 Elsevier Ltd. All rights reserved.