Online Program

Socioeconomic status, psychosocial factors, and cardiometabolic risk in the HCHS/SOL Sociocultural Ancillary Study

Tuesday, November 3, 2015

Jessica McCurley, M.S., Institute for Behavioral and Community Health, SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, CA
Scott Roesch, Ph.D., Department of Psychology, San Diego State University
Carmen Isasi, MD, PhD, Albert Einstein College of Medicine
Frank Penedo, PhD, Department of Medical Social Sciences / Northwestern University, Northwestern University, Chicago, IL
Patricia Gonzales, PhD, Graduate School of Public Health, San Diego State University, San Diego, CA
Alvaro Camacho, MD, MPH, Sun Valley Behavioral & Research Center, University of California, San Diego / San Diego State University, Imperial, CA
Neil Schneiderman, PhD, Department of Psychology, University of Miami, Coral Gables, FL
The metabolic syndrome (MetSyn) is defined as the presence of a cluster of interrelated metabolic risk factors (abdominal obesity, insulin resistance, dyslipidemia, and elevated blood pressure) and is associated with increased risk for cardiovascular disease and type 2 diabetes. Low socioeconomic status (SES) is associated with higher risk for MetSyn in Hispanic/Latino individuals and psychosocial factors may contribute to this relationship. Structural equation modeling (SEM) was used to examine the role of psychosocial variables in the association between SES and MetSyn in 5,312 Hispanic/Latino adults from the four U.S. field centers (Bronx, NY; Chicago, IL; Miami, FL; San Diego, CA) of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)-Sociocultural Ancillary Study. Participants aged 18-74 and from multiple Hispanic heritage groups (e.g., Mexican, Cuban, South-American) completed demographic information and measures of psychosocial risk (negative emotions and cognitions, such as depression and pessimism) and psychosocial resource (e.g., family cohesion, self-esteem) variables. MetSyn components were assessed as part of a baseline clinical exam. Confirmatory factor analysis was conducted to generate latent factors from each set of observed variables. Single latent factors were generated to represent SES (derived from observed variables of household income and education) and psychosocial risk/resilience (derived from observed risk and resource variables) separately. One, two, and three factor models for MetSyn variables were tested. The three-factor solution produced the best fit, with blood pressure (systolic, diastolic), lipids (high density lipoprotein cholesterol, triglycerides) and metabolic risk factors (waist circumference, glucose) comprising three separate latent factors. These factors were then used in the SEM analysis, which controlled for demographic (age, sex, language preference, Hispanic heritage group, field center) and medication (lipid- and blood pressure-lowering) variables. Lower SES was related to the three MetSyn factors indirectly through psychosocial factors (root mean square error of approximation [RMSEA] and standardized root-mean-square residual [SRMR] values <.06). A statistically significant mediated effect was found from lower SES to higher waist circumference/glucose via the lower psychosocial resources/higher psychosocial risk latent factor (95% CI = -0.120 to -0.036). Results suggest that psychosocial risk and resilience variables contribute to the association of SES with metabolic syndrome components in U.S. Hispanics/Latinos.

Learning Areas:

Chronic disease management and prevention
Diversity and culture
Social and behavioral sciences

Learning Objectives:
Evaluate the role of psychosocial variables in the association between socioeconomic status and the metabolic syndrome in Hispanic/Latino adults.

Keyword(s): Latinos, Diabetes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctoral student in clinical psychology and an NIH T32 Predoctoral Fellow in Cardiovascular Epidemiology at the University of California, San Diego. My research specialization is in Behavioral Medicine, with a focus on health disparities in cardiometabolic conditions in Latinos and other at-risk minority populations. I am first author of one publication on the topic of stress and glucose regulation in Latinos, and co-author of several related manuscripts focusing on Latino health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.