Life Course Socioeconomic Status, Social Context and Cardiovascular Disease: The LCSES Study Kathryn Rose, PhD for The LCSES Study Team

Background

LCSES and ARIC Studies  As part of the ARIC study, information on mid to later life socioeconomic status (SES) was collected at each of the four examinations  As an ancillary study, LCSES collected additional information from surviving participants about earlier life SES circumstances  Individual-level SES  Place of residence

LCSES Study Goals  Examine the association between SES across the life course and CVD-related outcomes  Determine the extent to which the current and historical (neighborhood) context modify the association of individual-level SES exposures and CVD events  Identify explanatory mechanisms for the SES- CVD association

LCSES Questionnaire  Administered during ARIC annual telephone follow-up (AFU)  44 questions about childhood and earlier adulthood social exposures Individual-level SES Military Service Place of residence –Used to link participants with historical census data

LCSES Participants  N = 12,716  80.5% of the baseline ARIC participants  Approximately 95% of cohort survivors

LCSES Participant Characteristics Black Women Black Men White Women White Men 16.5% 9.0% 40.8% 33.8% 29.5% 27.3% 23.7% 19.7% RACE/GENDER AGE at BASELINE

Type of Historical Data Collected Individual Level SES

Individual Level Childhood SES:  Mother and father’s (or other caretaker’s)  Education  Occupation Census-based categories analogous to those used in ARIC study Owner vs. worker Whether or not managed or supervised  Home ownership

Recalled Individual-level SES-Related Attributes in Earlier Adulthood  Occupation at ages 30, 40, and 50  Grouped into Bureau of Census Job Categories  Characteristics of Job  Owner vs. Worker  Managerial/Supervisory  Home ownership

Type of Historical Data Collected Contextual Level (Place of Residence)

Childhood Place of Residence  City / County / State of Residence during childhood  Data cleaning / editing  3% resided outside of the US  44% resided in the same county as in midlife  Linking with county-level census data  Chose decennial census (1930, 1940, 1950) that corresponded most closely to where participant lived at 10 years of age  Of the 12,314 participants who lived in the US as children, 99% were linked to county-level census data

Distribution of Participants by Birth Cohort ARIC Participant’s Birth Cohort Number

Place of Residence at Ages 30, 40, and 50  Participants asked to provide their complete street address  Goal: link with census tract data from historical census (1960 – 1980) most closely corresponding to the given age  Only queried about address for a given age if not already in ARIC at this age

Progress to Data  Strategies for working with complex historical census data have been developed  Individual and contextual / neighborhood socio- economic exposure data across the life course has been assembled for study participants  Various research projects focusing on cardiovascular disease related outcomes are in progress