Online Program

335221
Socioeconomic Status and Waist Circumference Is Associated With High Levels of High-Sensitivity C-Reactive Protein in Young Adults: An Analysis of ADHEALTH


Monday, November 2, 2015

Gniesha Dinwiddie, PhD, African American Studies Department, University of Maryland College Park, College Park, MD
Robert Turner, PhD, African American Studies Department, University of Maryland College Park, College Park, MD
Ronneal Mathews, Department of Family Science, Maryland Center for Health Equity, University of Maryland, School of Public Health, College Park, MD
Cardiovascular disease (CVD) is the leading cause of death and research consistently finds that racial and ethnic groups have high CVD morbidity and mortality.  However, the etiology of CVD risk factors are not well understood.   New studies suggests risk factors may begin to accumulate in early stages of the life course but there is a paucity of epidemiological based studies that examine the impact of risk factors in early adulthood by using biological markers of CVD risk.  The current investigation fills an important gap in our understanding of how variations in CVD risk begin in young adulthood by investigating the associations between social and health related risk factors with elevated levels of high sensitivity C-Reactive Protein (CRP), an acute phase inflammatory protein that has shown to be an independent predictor of atherosclerosis, myocardial infarction, stroke, peripheral vascular disease and sudden cardiac death.   Using secondary data from Waves I and IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health), the current study employs path models estimate pathways through which CRP is predicted by health condition, health behavior and psychosocial risk factors (i.e. high waist circumference, current smoker, alcohol intake, 10 item version of the CES-D) and five socioeconomic status indicators (i.e. respondent education, parental education, and proportion African American, Hispanic, and poverty in the census tract).  The population understudy includes 11,073 Non-Hispanic Whites (NHWs), 4,484 Non-Hispanic Blacks (NHBs) and 3,525 Hispanics.  Descriptive statistics indicate 32% of NHWs, 35% of NHBs and 36% of Hispanics had high levels of CRP (≤3mg/dl).  Results show high waist circumference were moderators of elevated CRP for NHWs, NHBs, and Hispanics with similar magnitude.  However, elevated CRP was explained through both parental and respondent education via high waist circumference (HWC) for NHWs.  For NHBs, CRP was explained thorough high proportion of residents living under poverty conditions and parental educational attainment via high waist circumference.  For Hispanics, results show a direct effect between parental education and elevated CRP but the association between respondent education and elevated CRP occurs via the HWC pathway.  Conclusions suggest weight reduction programs target young adult populations for CVD prevention with specific attention to poverty reduction in NHB communities and attention to the intergenerational transfer of education that impacts CVD risk in young adults.

Learning Areas:

Advocacy for health and health education
Chronic disease management and prevention
Diversity and culture
Epidemiology
Social and behavioral sciences

Learning Objectives:
Identify the social and health condition risk factors that are associated with elevated C-Reactive Protein, a marker of chronic stress and subsequent cardiovascular disease risk in adulthood. Compare how social and health condition risk factors vary by race/ethnicity and the pathways that best explain variation in elevated C-Reactive Protein for young adults aged 25-32 years of age Evaluate which social and health condition risk factors best explain disparities in C-Reactive Protein for Non-Hispanic Blacks, Non-Hispanic Whites, Hispanics.

Keyword(s): Chronic Disease Prevention, Epidemiology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal investigator of grants that have examined the social risk factors implicated in health disparities for minority populations. My scientific interests have shed light on how social risk factors account for much of the variance in traditional measures (i.e. hypertension, obesity, diabetes) and novel measures (i.e. C-Reactive Protein) of cardiovascular disease risk for minority populations including African Americans and Latinos.
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.