Household Income and Cardiovascular Disease Risks in US Children and Young Adults Analyses from NHANES 1999-2008

• Type of Material: Article
• Authors: Mohammed K Ali, Emory University; Kai McKeever Bullard, Centers for Disease Control and Prevention; Gloria L. Beckles, Centers for Disease Control and Prevention; Mark R. Stevens, Centers for Disease Control and Prevention; Lawrence Barker, Centers for Disease Control and Prevention; K.M. Venkat Narayan, Emory University; Giuseppina Imperatore, Centers for Disease Control and Prevention
• Language: English
• Date: 2011-09-01
• Publisher: American Diabetes Association
• Publication Version: Final Published Version
• Copyright Statement: © 2011 by the American Diabetes Association.
• License: Creative Commons Attribution-NoDerivs-NonCommercial 1.0 Generic
• Final Published Version (URL): http://dx.doi.org/10.2337/dc11-0792
• Title of Journal or Parent Work: Diabetes Care
• ISSN: 0149-5992
• Volume: 34
• Issue: 9
• Start Page: 1998
• End Page: 2004
• Grant/Funding Information: Data collection for NHANES is sponsored by the Department of Health and Human Services.; These secondary study analyses were not supported by grants or any specific funding source.
• Keywords: CHILDHOOD; HEALTH; Endocrinology & Metabolism; LIFE; Life Sciences & Biomedicine; CORONARY-HEART-DISEASE; SOCIOECONOMIC POSITION; OBESITY; Science & Technology; DENSITY
• Research Categories: Home Economics; Health Sciences, Public Health

Abstract

OBJECTIVE - To assess the cardiovascular risk profile of youths across socioeconomic groups in the U.S. RESEARCH DESIGN AND METHODS - Analysis of 1999-2008 National Health and Nutrition Examination Surveys (NHANES) including 16,085 nonpregnant 6- to 24-year-olds to estimate race/ethnicity-adjusted prevalence of obesity, central obesity, sedentary behaviors, tobacco exposure, elevated systolic blood pressure, glycated hemoglobin, non-HDL cholesterol (non-HDL-C), and high-sensitivity C-reactive protein according to age-group, sex, and povertyincome ratio (PIR) tertiles. RESULTS - Among boys aged 6-11 years, 19.9% in the lowest PIR tertile were obese and 30.0% were centrally obese compared with 13.2 and 21.6%, respectively, in the highest-income tertile households (P obesity < 0.05 and P central obesity < 0.01). Boys aged 12-17 years in lowest-income households were more likely than their wealthiest family peers to be obese (20.6 vs. 15.6%, P < 0.05), sedentary (14.8 vs. 9.3%, P < 0.05), and exposed to tobacco (19.0 vs. 6.5%, P < 0.01). Compared with girls aged 12-17 years in highest-income households, lowest-income household girls had higher prevalence of obesity (17.9 vs. 13.1%, P < 0.05), central obesity (41.5 vs. 29.2%, P < 0.01), sedentary behaviors (20.4 vs. 9.4%, P < 0.01), and tobacco exposure (14.1 vs. 5.9%, P < 0.01). Apart from higher prevalence of elevated non-HDL-C among low-income women aged 18-24 years (23.4 vs. 15.8%, P < 0.05), no other cardiovascular disease risk factor prevalence differences were observed between lowest- and highest-income background young adults. CONCLUSIONS - Independent of race/ethnicity, 6- to 17-year-olds from low-income families have higher prevalence of obesity, central obesity, sedentary behavior, and tobacco exposure. Multifaceted cardiovascular health promotion policies are needed to reduce health disparities between income groups.