Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/12953
Title: Associations of life course socioeconomic position and job stress with carotid intima-media thickness. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
Authors: Camelo, Lidyane V.
Giatti, Luana
Chor, Dóra
Griep, Rosane Härter
Benseñor, Isabela M.
Santos, Itamar S.
Kawachi, Ichiro
Barreto, Sandhi Maria
Affilliation: Universidade Federal de Minas Gerais. Faculdade de Medicina. Programa de Pós-Graduação em Saúde Pública. Belo Horizonte, MG, Brasil / Harvard School of Public Health. Department of Social and Behavioral Sciences. Boston, MA, USA.
Universidade Federal de Minas Gerais. Faculdade de Medicina. Programa de Pós-Graduação em Saúde Pública. Belo Horizonte, MG, Brasil / Universidade Federal de Ouro Preto. Escola de Nutrição. Ouro Preto, MG, Brasil.
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Educação em Ambiente e Saúde. Rio de Janeiro, RJ, Brasil.
Universidade de São Paulo. Hospital Universitário. Centro para Pesquisa Clínica e Epidemiológica. São Paulo, SP, Brasil.
Universidade de São Paulo.Escola de Medicina. Departamento de Medicina Interna. São Paulo, SP, Brasil.
Harvard School of Public Health. Department of Social and Behavioral Sciences. Boston, MA, USA.
Universidade Federal de Minas Gerais. Faculdade de Medicina. Programa de Pós-Graduação em Saúde Pública. Belo Horizonte, MG, Brasil.
Abstract: Rationale: The association between life course socioeconomic position (SEP) and subclinical atherosclerosis is not consistent across studies. Socioeconomic adversities early in life are related to an increased probability of a low occupational grade and more stressful jobs in adulthood. However, the role of job stress in explaining the life course social gradient in subclinical atherosclerosis is unknown. Objectives: To examine whether life course SEP is associated with carotid intima-media thickness (IMT) and to investigate whether this association is partially mediated by job stress. Methods: This study used baseline data (2008e2010) for 8806 current workers from ELSAeBrasil. Maternal education, social class of first occupation and social class of current occupation were used to evaluate childhood, youth and adulthood SEP, respectively. Accumulation of risk across the life course was also evaluated. Job stress was assessed by the Swedish DemandeControleSupport Questionnaire. Directed acyclic graph and linear regression models were used. Results: Low childhood SEP was associated with increased IMT only in women, but low youth and adulthood SEP were associated with higher IMT in both genders. The simultaneous adjustment for all SEP indicators showed that only adulthood SEP continued to be associated with IMT. However, higher IMT values were observed among men and women sequentially exposed to low SEP in more than one period of life. High-strain jobs and low job control were not associated with IMT independent of SEP. Conclusion: Our results support a model of the cumulative effects of exposures to SEP across the life span because the highest IMT values were observed in individuals sequentially exposed to low SEP in more than one period of life. We did not find that job stress explained the association between life course SEP and IMT, suggesting that strategies to address socioeconomic inequalities in CVD should target additional steps beyond reducing job stress.
Keywords: Life course
Health inequalities
Socioeconomic position
Atherosclerosis
IMT
Job stress
Cardiovascular disease
keywords: Desigualdades em Saúde
Arteriosclerose
Estresse no trabalho
Doenças cardiovasculares
Saúde pública
Issue Date: 2015
Publisher: Elsevier
Citation: CAMELO, Lidyane V. et al. Associations of life course socioeconomic position and job stress with carotid intima-media thickness. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Social Science & Medicine, v.141, p.91-99, Sept. 2015.
DOI: 10.1016/j.socscimed.2015.07.032
ISSN: 0037-7856
Copyright: open access
Appears in Collections:ENSP - Artigos de Periódicos
IOC - Artigos de Periódicos

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