Table 2.
Associations of socioeconomic status (SES) with incident cardiovascular disease (CVD) and mortality and mediation proportion of socioeconomic inequity in health attributed to lifestyle*
| Hazard ratio (95% CI) | Mediation proportion (%) (95% CI) | ||
|---|---|---|---|
| Unadjusted for lifestyle score | Adjusted for lifestyle score | ||
| All cause mortality | |||
| US NHANES: | |||
| High SES | 1 (Reference) | 1 (Reference) | - |
| Medium SES | 1.67 (1.51 to 1.84) | 1.57 (1.42 to 1.73) | 11.9 (9.6 to 14.2) |
| Low SES | 2.36 (2.11 to 2.65) | 2.13 (1.90 to 2.38) | 12.3 (10.7 to 13.9) |
| UK Biobank: | |||
| High SES | 1 (Reference) | 1 (Reference) | - |
| Medium SES | 1.31 (1.25 to 1.37) | 1.29 (1.23 to 1.35) | 5.1 (4.0 to 6.5) |
| Low SES | 2.02 (1.92 to 2.12) | 1.96 (1.87 to 2.06) | 4.0 (3.5 to 4.4) |
| CVD in UK Biobank | |||
| CVD mortality: | |||
| High SES | 1 (Reference) | 1 (Reference) | - |
| Medium SES | 1.33 (1.19 to 1.49) | 1.31 (1.17 to 1.47) | 4.6 (2.8 to 7.2) |
| Low SES | 2.31 (2.06 to 2.59) | 2.25 (2.00 to 2.53) | 3.0 (2.5 to 3.6) |
| Incident CVD: | |||
| High SES | 1 (Reference) | 1 (Reference) | - |
| Medium SES | 1.29 (1.20 to 1.39) | 1.28 (1.18 to 1.38) | 4.1 (2.8 to 5.9) |
| Low SES | 1.69 (1.55 to 1.83) | 1.65 (1.52 to 1.79) | 3.7 (3.1 to 4.5) |
US NHANES=US National Health and Nutrition Examination Survey.
SES was generated through latent class analysis using information on family income to poverty ratio, occupation, education, and health insurance in US NHANES, and household income, education, and employment status in UK Biobank. All models included age, sex, marital status (US NHANES only), self-reported race, acculturation, study center (UK Biobank only), body mass index, and prevalent comorbidities (including history of hypertension, diabetes, CVD, cancer, chronic bronchitis, emphysema, or chronic obstructive pulmonary disease). The healthy lifestyle score consisted of never smoking, no heavy alcohol consumption, higher physical activity level, and a higher diet quality score. Analysis in US NHANES included the US population and study design weights to account for the complex survey design. Only those free from CVD at baseline were included in the analysis for incident CVD.