Social
Education and Income trajectories of CARDIA Participants and their Association with Early Adulthood Identity-based Discrimination and Late Adulthood Cardiovascular Health Adovich Rivera* Adovich Rivera B.R. Slone Grace V. Avila Stephanie Hernandez Gregory Phillips II Patrick Janulis Mercedes Carnethon Ankeet S. Bhatt James M. Shikany Cora E. Lewis Pamela Schreiner Lauren B. Beach
Cardiovascular health (CVH) as measured through attaining ideal behavior (e.g., not smoking) is associated with lower CV disease risk. While socioeconomic position (SEP) is a known driver of CVD risk, its role in CVH via a life course approach is less studied. Also, discrimination is theorized to adversely affect SEP, but more studies are needed. We investigated the interrelationships of experienced discrimination, income/education trajectories, and CVH using Coronary Artery Risk Development in Young Adults (CARDIA) cohort data.
We first identified Year (Y) 7-35 education and income trajectories using sequence and cluster analysis based on optimal matching for dissimilarities calculation and hierarchical agglomerative clustering. This approach uncovers heterogeneity in SEP trajectories which maybe hidden in methods focused on averages. We then assessed if the clusters differed by Life’s Simple 7 (LS7) score, a CVH measure, in older adulthood (Y35) with linear models adjusted for race, sex, age, and CARDIA field center. Lastly, we assessed if cluster membership differed by race, sex, or sexual orientation discrimination in early adulthood (Y7) with multinomial models adjusted for the above covariates.
Our analysis (n=3905) identified 5 education and 5 income clusters based on the Calisnki-Harabasz index (Figure). We found that clusters with lower educational attainment (clusters 3 & 4) and low income (clusters 2 & 3) had significantly lower Y35 LS7 scores than cluster 1. Those reporting Y7 gender or race discrimination had a lower probability of being in education cluster 4. Gender discrimination was also associated with lower probability of being in income cluster 3. Sexual orientation discrimination was not associated with membership.
In sum, we uncovered heterogeneous SEP trajectories with different CVH scores in later life. Early adulthood discrimination was associated with SEP trajectories. Further work is recommended to uncover mechanisms of these associations.
