7 research outputs found
Psychological, social and biological determinants of ill health (pSoBid): study protocol of a population-based study
Background: Disadvantaged communities suffer higher levels of physical and mental ill health than more advantaged communities. The purpose of the present study was to examine the psychosocial, behavioural and biological determinants of ill health within population groups in Glasgow that differed in socioeconomic status and in their propensity to develop chronic disease especially coronary heart disease and Type 2 diabetes mellitus.
Methods: Participants were selected at random from areas known to be at the extremes of the socioeconomic continuum in Glasgow. Within the categories of least deprived and most deprived, recruitment was stratified by sex and age to achieve an overall sample containing approximately equal numbers of males and females and an even distribution across the age categories 35â44, 45â 54 and 55â64 years. Individuals were invited by letter to attend for assessment of their medical history, risk factor status, cognitive function and psychological profile, morbidity, and carotid intima-media thickness and plaque count as indices of atherosclerosis. Anonymised data on study subjects were collected from the General Practice Administration System for Scotland to analyse
characteristics of participants and non-participants
Differences in atherosclerosis according to area level socioeconomic deprivation: cross sectional, population based study
Objectives To examine the relation between area level
social deprivation and ultrasound markers of
atherosclerosis (common carotid intima-media thickness
and plaque score), and to determine whether any
differences can be explained by âclassicâ (currently
recognised) or âemergingâ (novel) cardiovascular risk
factors.
Design Cross sectional, population based study.
Setting NHS Greater Glasgow Health Board area.
Participants 666 participants were selected on the basis
of how their area ranked in the Scottish Index of Multiple
Deprivation 2004. Approximately equal numbers of
participants from the most deprived areas and the least
deprived areas were included, as well as equal numbers
of men and women and equal numbers of participants
from each age group studied (35-44, 45-54, and
55-64 years).
Main outcome measures Carotid intima-media thickness
and plaque score, as detected by ultrasound.
Results The mean age and sex adjusted intima-media
thickness was significantly higher in participants from the
most deprived areas than in those from the least deprived
areas (0.70 mm (standard deviation (SD) 0.16 mm) v
0.68mm(SD 0.12 mm); P=0.015). On subgroup analysis,
however, this difference was only apparent in the highest
age tertile in men (56.3-66.5 years). The difference in
unadjusted mean plaque score between participants
from the most deprived and those from the least deprived
areas was more striking than the difference in intimamedia
thickness (least deprived 1.0 (SD 1.5) v most
deprived 1.7 (SD 2.0); P<0.0001). In addition, a significant
difference in plaque score was apparent in the two
highest age tertiles in men (46.8-56.2 years and 56.3-66.
5 years; P=0.0073 and P<0.001) and the highest age
tertile in women (56.3-66.5 years; P<0.001). The
difference in intima-media thickness between most
deprived and least deprived males remained significant
after adjustment for classic risk factors, emerging risk
1.7 (SD 2.0); P<0.0001). In addition, a significant
difference in plaque score was apparent in the two
highest age tertiles in men (46.8-56.2 years and 56.3-66.
5 years; P=0.0073 and P<0.001) and the highest age
tertile in women (56.3-66.5 years; P<0.001). The
difference in intima-media thickness between most
deprived and least deprived males remained significant
after adjustment for classic risk factors, emerging risk
factors, and individual level markers of socioeconomic
status (P=0.010). Adjustment for classic risk factors and
emerging cardiovascular risk factors, either alone or in
combination, did not abolish the deprivation based
difference in plaque presence (as a binary measure;
adjusted odds ratio of 1.73, 95% confidence interval 1.07
to 2.82). However, adjustment for classic risk factors and
individual level markers of early life socioeconomic status
abolished the difference in plaque presence between the
most deprived and the least deprived individuals
(adjusted odds ratio 0.94, 95% CI 0.54 to 1.65; P=0.84).
Conclusions Deprivation is associated with increased
carotid plaque score and intima-media thickness. The
association of deprivation with atherosclerosis is
multifactorial and not adequately explained by classic or
emerging risk factors
Early life socioeconomic adversity is associated in adult life with chronic inflammation, carotid atherosclerosis, poorer lung function and decreased cognitive performance: a crosssectional, population-based study
Background: Socioeconomic gradients in health persist despite public health campaigns and improvements in healthcare. The Psychosocial and Biological Determinants of Ill-health (pSoBid) study was designed to uncover novel biomarkers of chronic disease that may help explain pathways between socioeconomic adversity and poorer physical and mental health.
Methods: We examined links between indicators of early life adversity, possible intermediary phenotypes, and markers of ill health in adult subjects (n = 666) recruited from affluent and deprived areas. Classical and novel risk factors for chronic disease (lung function and atherosclerosis) and for cognitive performance were assessed, and associations sought with early life variables including conditions in the parental home, family size and leg length.
Results: Associations were observed between fatherâs occupation, childhood home status (owner-occupier; overcrowding) and biomarkers of chronic inflammation and endothelial activation in adults (C reactive protein, interleukin 6, intercellular adhesion molecule; P < 0.0001) but not number of siblings and leg length. Lung function (forced expiratory volume in 1 second) and cognition (Choice Reaction Time, the Stroop test, Auditory Verbal Learning Test) were likewise related to early life conditions (P < 0.001). In multivariate models inclusion of inflammatory variables reduced the impact and independence of early life conditions on lung function and measures of cognitive ability. Including variables of adult socioeconomic status attenuated the early life
associations with disease biomarkers.
Conclusions: Adverse levels of biomarkers of ill health in adults appear to be influenced by fatherâs occupation and childhood home conditions. Chronic inflammation and endothelial activation may in part act as intermediary phenotypes in this complex relationship. Reducing the âhealth divideâ requires that these life course determinants
are taken into account
Personality, socio-economic status and inflammation: cross-sectional, population-based study
Background: Associations between socio-economic status (SES), personality and inflammation were examined to determine
whether low SES subjects scoring high on neuroticism or hostility might suffer relatively higher levels of inflammation than
affluent subjects.
Methods: In a cross-sectional design, 666 subjects were recruited from areas of high (most deprived â ââMDââ) and low (least
deprived â ââLDââ) deprivation. IL-6, ICAM-1, CRP and fibrinogen were measured along with demographic and healthbehaviour
variables, and personality traits of neuroticism, extraversion and psychoticism (hostility). Regression models
assessed the prediction of inflammation as a function of personality, deprivation and their interaction.
Results: Levels of CRP and IL-6 were an increasing function of neuroticism and extraversion only in LD subjects opposite
trends were seen in MD subjects. The result was ascribed parsimoniously to an inflammatory ceiling effect or, more
speculatively, to SES-related health-behaviour differences. Psychoticism was strongly associated with ICAM-1 in both MD
and LD subjects.
Conclusions: The association between neuroticism, CRP and IL-6 may be reduced in MD subjects confirming speculation
that the association differs across population sub-groups. The association between psychoticism and ICAM-1 supports
evidence that hostility has adverse effects upon the endothelium, with consequences for cardiovascular health. Health
interventions may be more effective by accounting for personality-related effects upon biological processes
Associations between personality traits and health behaviours in affluent and deprived groups, and their interactions.
a<p>BMI (body mass index).</p>b<p>Depressionâ=âdepression sub-scale of GHQ-28.</p>c<p>NART (National Adult Reading Test).</p
Levels of inflammatory markers as a function of the interaction between personality and deprivation group with 95% confidence bands.
<p>Levels of inflammatory markers as a function of the interaction between personality and deprivation group with 95% confidence bands.</p
Description of basic demographics, socioeconomic status, personality and markers of inflammation by area deprivation category.
a<p>Values are presented as Mean (SD) for all participants; or as percentages for categorical variables, adjusted for age and sex;</p>b<p><i>P</i> relates the comparison between the two groups. Categorical variables were compared using Fisherâs exact test, continuous variables were compared using t-tests or Wilcoxon tests as appropriate.</p>c<p>The occupational category could not be determined for nâ=â1 (0.3%) and nâ=â16 (5%) of the LD and MD groups respectively. Occupation classified using Registrar General Social Class Classification on basis of current job or, if not currently working, on the basis of participantsâ last paid job. Only those who had never been in paid employment were classed as âunemployed.â I - professional occupations; II - managerial and technical occupations; III - manual and non-manual skilled occupations; IV - partly skilled occupations; V - unskilled occupations.</p>d<p>Diet score is the participants self-reported consumption of fruit and vegetables (fresh, cooked and raw) per month.</p>e<p>Physical activity level is a combination of activity at work and recreational exercise.</p>f<p>Data log transformed prior to regression analysis.</p>g<p>Personality trait scores were self-reported, each on a scale of 1 to 12.</p>h<p>Depressionâ=âdepression sub-scale of GHQ-28.</p>i<p>NART (National Adult Reading Test).</p