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Am J Public Health. 2009 Jul;99(7):1278-84. doi: 10.2105/AJPH.2008.147934. Epub 2009 May 14.

Impact of social position on the effect of cardiovascular risk factors on self-rated health.

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  • 1Inserm UMR558, Toulouse, France. cyrildelpierre@yahoo.fr

Abstract

OBJECTIVES:

We assessed the impact of education level on the association between self-rated health and cardiovascular risk factors (blood pressure, glycosylated hemoglobin level, and total cholesterol and triglyceride levels).

METHODS:

We used data from the National Health and Nutrition Examination Survey for the years 2001 through 2004 (4015 men and 4066 women). Multivariate analyses were performed with a logistic regression model.

RESULTS:

After adjustment for age and ethnicity, among women with high glycosylated hemoglobin levels, the most-educated women had poorer self-rated health compared with the least-educated women (odds ratio [OR] = 4.61; 95% confidence interval [CI] = 2.90, 7.34 vs OR = 2.59; 95% CI = 1.60, 4.20, respectively; interaction test, P = 0.06). The same was true among women with high cholesterol levels (OR = 2.23; 95% CI = 1.40, 3.56 vs OR = 1.13; 95% CI = 0.85, 1.49, respectively; interaction test, P = 0.06). Among men, the impact of education level on the association between self-rated health and any cardiovascular risk factors (measured or self-reported) was not significant.

CONCLUSIONS:

The impact of cardiovascular risk factors on self-rated health was higher for highly educated women, which could lead to underestimation of health inequalities between socioeconomic groups when self-rated health is used as an indicator of objective health.

PMID:
19443823
[PubMed - indexed for MEDLINE]
PMCID:
PMC2696651
Free PMC Article
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