Table 5.
Adjusted Hazard Ratios for the Association Between Individual-Level Socioeconomic Exposures Across the Life Course and Incident Heart Failure, by Racial/Ethnic Group, ARIC LC-SES Study, 1987–2004a
| Individual-Level Socioeconomic Indicator From Early Lifeb | Blacks (n = 2,503) |
Whites (n = 8,519) |
||||||||||||
| No. of Heart Failure Events | Model 1 |
Model 2 |
Model 3 |
No. of Heart Failure Events |
Model 1 |
Model 2 |
Model 3 |
|||||||
| HR | 95% CI | HR | 95% CI | HR | 95% CI | HR | 95% CI | HR | 95% CI | HR | 95% CI | |||
| Parental education | ||||||||||||||
| ≤8th grade | 78 | 1.80 | 1.14, 2.84 | 1.52 | 0.95, 2.42 | 1.31 | 0.82, 2.09 | 191 | 1.44 | 1.16, 1.79 | 1.31 | 1.06, 1.64 | 1.20 | 0.96, 1.49 |
| 9th–11th grade | 121 | 1.50 | 0.93, 2.41 | 1.33 | 0.82, 2.14 | 1.24 | 0.76, 2.01 | 187 | 1.41 | 1.14, 1.74 | 1.26 | 1.01, 1.57 | 1.19 | 0.95, 1.48 |
| ≥12th grade | 22 | 1.00 | 1.00 | 1.00 | 159 | 1.00 | 1.00 | 1.00 | ||||||
| Parental occupationc | ||||||||||||||
| Nonprofessional | 60 | 1.11 | 0.83, 1.50 | 1.03 | 0.76, 1.39 | 1.08 | 0.80, 1.46 | 45 | 1.24 | 0.91, 1.69 | 1.18 | 0.87, 1.60 | 1.04 | 0.77, 1.42 |
| Managerial and professional | 161 | 1.00 | 1.00 | 1.00 | 492 | 1.00 | 1.00 | 1.00 | ||||||
| Home ownership | ||||||||||||||
| No | 141 | 1.42 | 1.08, 1.87 | 1.24 | 0.93, 1.66 | 1.18 | 0.89, 1.58 | 150 | 0.90 | 0.74, 1.09 | 0.85 | 0.70, 1.04 | 0.83 | 0.68, 1.01 |
| Yes | 80 | 1.00 | 1.00 | 1.00 | 387 | 1.00 | 1.00 | 1.00 | ||||||
Abbreviations: ARIC, Atherosclerosis Risk in Communities; CI, confidence interval; HR, hazard ratio; LC-SES, Life Course Socioeconomic Status, Social Context, and Cardiovascular Disease; SEP, socioeconomic position.
In model 1, results were adjusted for demographic characteristics (age, gender, and study center). In model 2, results were adjusted for all of the factors in model 1 + young adulthood SEP + mid-to-older adulthood SEP. In model 3, results were adjusted for all of the factors in model 2 + body mass index, type 2 diabetes, hypertension, left ventricular hypertrophy, prevalent coronary heart disease, current smoking status, current alcohol drinking status, and health insurance (yes or no).
Early-life individual socioeconomic indicators reflect parents’ educational level, class, and home ownership status when the participant was 10 years of age. Data on indicators of early-life SEP were collected retrospectively during the LC-SES Study (2001).
Occupation was defined on the basis of the National Statistics Socio-economic Classification (27).