Article
Associations of life course socioeconomic position and job stress with carotid intima-media thickness. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
Registro en:
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.
0037-7856
10.1016/j.socscimed.2015.07.032
Autor
Camelo, Lidyane V.
Giatti, Luana
Chor, Dóra
Griep, Rosane Harter
Bensenor, Isabela
Santos, Itamar S.
Kawachi, Ichiro
Barreto, Sandhi Maria
Resumen
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.