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首页> 外文期刊>Annals of epidemiology >Lifecourse social conditions and racial disparities in incidence of first stroke.
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Lifecourse social conditions and racial disparities in incidence of first stroke.

机译：终生中风的社会状况和种族差异。

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PURPOSE: Some previous studies found excess stroke rates among black subjects persisted after adjustment for socioeconomic status (SES), fueling speculation regarding racially patterned genetic predispositions to stroke. Previous research was hampered by incomplete SES assessments, without measures of childhood conditions or adult wealth. We assess the role of lifecourse SES in explaining stroke risk and stroke disparities. METHODS: Health and Retirement Study participants age 50+ (n = 20,661) were followed on average 9.9 years for self- or proxy-reported first stroke (2175 events). Childhood social conditions (southern state of birth, parental SES, self-reported fair/poor childhood health, and attained height), adult SES (education, income, wealth, and occupational status) and traditional cardiovascular risk factors were used to predict first stroke onset using Cox proportional hazards models. RESULTS: Black subjects had a 48% greater risk of first stroke incidence than whites (95% confidence interval, 1.33-1.65). Childhood conditions predicted stroke risk in both blacks and whites, independently of adult SES. Adjustment for both childhood social conditions and adult SES measures attenuated racial differences to marginal significance (hazard ratio, 1.13; 95% CI, 1.00-1.28). CONCLUSIONS: Childhood social conditions predict stroke risk in black and White American adults. Additional adjustment for adult SES, in particular wealth, nearly eliminated the disparity in stroke risk between black and white subjects.
机译：目的：先前的一些研究发现，在调整了社会经济状况（SES）之后，黑人受试者中的过高卒中发生率仍然存在，这引发了有关种族中风遗传易感性的推测。 SES评估不完善，无法衡量儿童状况或成人财富，从而阻碍了先前的研究。我们评估了生命过程SES在解释中风风险和中风差异方面的作用。方法：健康和退休研究参与者对50岁以上（n = 20,661）的患者进行了平均9.9年的自我报告或代理报告的中风（2175事件）。使用儿童的社会状况（出生时的南部状况，父母的SES，自我报告的公平/较差的儿童健康状况以及达到的身高），成人的SES（教育程度，收入，财富和职业状况）和传统的心血管危险因素来预测首次卒中使用Cox比例风险模型进行发病。结果：黑人受试者的中风发病率比白人高48％（95％置信区间1.33-1.65）。童年时期的状况可预测黑人和白人中风的风险，与成人SES无关。调整儿童的社会状况和成年的SES措施可减少种族差异至边际意义（危险比，1.13; 95％CI，1.00-1.28）。结论：儿童的社会状况预测了美国黑人和白人成年人的中风风险。对成人SES（尤其是财富）的额外调整几乎消除了黑人和白人受试者中风风险的差异。

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