MacArthur SES & Health Network
MacArthur SES & Health Network

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Integrative Studies

1. Coronary Artery Risk Development in Young Adults (CARDIA) Study

Core group members and network collaborators continue to mine the data from this longitudinal study of cardiovascular risk factors among African-Americans and Whites in four U.S. cities (Birmingham, Chicago, Minneapolis and Oakland). The study recruited 5115 men and women in l985 stratified by age (18-24 years and 25-30 years), sex, ethnicity (black and white), and educational level (high school graduate or less and beyond high school). Seven follow-ups have been conducted, and retention has been good. A particular strength of this study is the availability of excellent measures of socioeconomic status, psychosocial factors, and biological indicators in a diverse population, including data from the sociodemographic and psychosocial questionnaires, and the allostatic load battery of biological measures, all of which the network designed for the 15-year (2000-2001) CARDIA exam. With repeated measures of SES, major cardiovascular risk factors, and health outcomes, including hypertension, diabetes, obesity, metabolic syndrome and coronary calcification this data set is a rich resource for testing our pathways model. Analysis centers are established at UCLA, Stony Brook and UCSF.

Table 1. CARDIA Analyses Involving MacArthur Network Core Group Members and Affiliates

Title of Project Writing Group Analysis Site Status
Development of psychometrically-sound measures for the CARDIA Year 15 exam. Seeman, Matthews, McCreath and Network UCLA Documentation completed in 2002.
Relation of childhood socioeconomic status and family environment to adult metabolic functioning. Lehman, Taylor, Kiefe, Seeman UCLA Published in 2005.
Does cardiovascular reactivity to mental stress predict coronary calcification? Matthews, Markovitz CC Published in 2005.
Impact of Socio-Economic Status on Longitudinal Accumulation of Cardiovascular Risk in Young Adults: The CARDIA Study. Karlamangla, Singer, Williams, Schwartz, Matthews, Kiefe, Seeman UCLA Published in 2005.
Socioeconomic status and health: Is parasympathetic nervous system activity an intervening mechanism? Sloan, Huang, Sidney, Liu, Williams, Seeman UCLA Published in 2005.
Socioeconomic status, race, and diurnal cortisol decline. Cohen, Schwartz, Epel, Kirschbaum, Sidney, Seeman Stony Brook Published in 2006.
Education, 15-year risk factor progression, and coronary artery calcium in young adulthood and early middle age. Yan, Liu, Daviglus, Colangelo, Kiefe, Sidney, Matthews, Greenland CC Published in 2006.
Self-reported health, perceived racial discrimination, and skin color in African Americans Borrell, Kiefe, Williams, Diez-Roux, Gordon-Larsen CC Published in 2006.

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Relationship of early life stress and psychological functioning to c-reactive protein. Taylor, Lehman, Kiefe, Seeman UCLA Published in 2006.
Diurnal cortisol decline is related to coronary calcification. Matthews, Schwartz, Cohen, Seeman Stony Brook Published in 2006.
Socioeconomic trajectories, childhood socioeconomic status, and coronary calcification in adulthood. Includes Year 20 data. Matthews, Schwartz, Cohen, Yan Stony Brook Manuscript in preparation.
Cardiac autonomic control and the effects of age, race, and gender Sloan, Seeman, Sidney, Liu, Dale, Williams UCLA Published in 2008.
Modeling multi-system biological risk in young adults. (Ancillary #1) Seeman, Gruenewald, Schwartz, Sidney, Liu, McEwen, Karlamangla UCLA Resubmitted.
A follow-up paper to the previous one will be prepared that examines the relationship of this formulation of allostatic load to health outcomes. Seeman, Gruenewald, Schwartz, Sidney, Liu, McEwen, Karlamangla UCLA Analyses to begin once previous manuscript is accepted for publication.
Subjective social status in relationship to blood pressure, coronary calcification, and waist-to-hip ratio: Are there effects above and beyond the standard SES measures and negative emotions? Adler, Singh-Manoux, Schwartz, Stewart, Matthews, Marmot StonyBrook
Published in 2008.
The relationship of early family environment to blood pressure. Lehman, Taylor, Kiefe, Seeman UCLA Published in 2009.
Occupational history and risk for hypertension. Seeman, Burgard, Schwartz, Stewart, Matthews Stony Brook Manuscript in preparation.

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Subjective Social Status Qualitative Study Connor, Stewart, Sidney, Adler UCSF Manuscript nearly completed; considering incorporation of psychosocial analyses.
Allostatic load and its relationship to socioeconomic status and social support Seeman, McEwen, Singer, Kiefe, Williams UCLA Manuscript in preparation.
Are psychological factors related to abnormal diurnal ambulatory blood pressure patterns in young adults? Shimbo, Davidson, Haas, Lewis, Pickering, Schwartz CC/Stony Brook Findings negative, unlikely to complete manuscript.
Do depressive symptoms moderate the link between low socioeconomic status and diabetes incidence? Davidson, Schwartz Stony Brook Manuscript in preparation.
Perceptions of discrimination and hypertension. Williams, Pletcher, Kiefe, Matthews, Sidney CC/ESC Analyses in progress.
Perceived discrimination and coronary calcification. Williams, Kiefe, Matthews, Sidney CC/ESC Analyses in progress.
Discrimination and metabolic syndrome. Ahmed, Sidney, Matthews, Williams Oakland/UCLA Analyses in progress.
Anabolic (IGF-1) and catabolic (urinary cortisol and catecholamine) hormones in relationship to depression, chronic stress, and disease risk (coronary calcification, insulin resistance and visceral fat). Epel, Sidney UCSF Analyses in progress.
Hostility and pulmonary function in CARDIA: A 10-year prospective study. Jackson, Jacobs, Kubzansky, Cohen, Wright Stony Brook Published in 2007.
Allostatic load as a mediator of SES differences in coronary calcification (Ancillary #2) Seeman, Singer, McEwen, Karlamangla Matthews, Sidney UCLA Revised proposal to be submitted to look at change in CAC (yr 15-20).

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A Multilevel Analysis of Neighborhood SES and Social Cohesion As Predictors of Allostatic Load and Coronary Calcification Kim, Diez-Roux, Kiefe, Williams, Kawachi, Liu, Seeman Harvard/UCLA Manuscript is being circulated to co-authors.
Neighborhood socioeconomic status, social cohesion, and coronary calcification in young adults. Kim, Diez Roux, Kiefe, Kawachi, Liu By Diez-Roux Analyses in progress.
Experience of discrimination in CARDIA: Ethnicity, gender, and socioeconomic position.
(Patterns of experience of perception and change over time.)
Williams, Kiefe, Matthews, Sidney CC Analyses in progress.
Socioeconomic status and inflammation. Gruenewald, Seeman, Cohen, Tracy, Matthews, Britt, Liu UCLA Manuscript under review by CARDIA—to be submitted to a journal in 2008.
RR interval variability and inflammation. Sloan, McCreath, Tracey, Sidney, Liu, Seeman UCLA Published in 2007.
Affect, Stress, SES, and Salivary Cortisol Epel, Schwartz, Matthews, Adler, Seeman, Haritatos Stony Brook Analyses in progress.
Heart rate variability and coronary calcification Sloan, Matthews, Seeman UCLA Analyses in progress.
Visceral Fat, psychosocial distress and HPA axis function Epel, Stewart, Adler, Sidney, Seeman UCSF Analyses in progress.
Race, Stress and Health: A lifecourse perspective Nuru-Jeter, Diez-Roux, Williams, Adler, Sidney, Seeman UCSF Analyses in progress.
Cellular aging, psychosocial factors, and risk of cardiovascular disease Epel, Adler, Seeman, Pletcher, Hulley, Cawthon Blackburn, Lin UCSF Analyses in progress.
Socioeconomic status is related to urinary catecholamines in CARDIA. Janicki-Deverts, Cohen, Adler, Schwartz, Matthews, Seeman Stony Brook Published in 2007.
SES over the lifecourse and oxidative stress Janicki-Deverts, Cohen, Matthews, Gross, Jacobs Stony Brook Published in 2009.

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SES trajectories and changes in health practices Janicki-Deverts, Cohen, Matthews, Schwartz, Kiefe, Daviglus Stony Brook Written into Denise Janicki-Deverts' NIH grant.
Risk factor profiles linked to self-rated health. Nayak, Hubbard, Kiefe, Sidney, Adler, Syme UCSF Analyses in progress.
Relationship of SES to a range of psychosocial factors that are studied in biopsychosocial research. Schwartz and Network Psychosocial Group Stony Brook Analyses completed; a manuscript proposal will soon be submitted to CARDIA P & P committee.
The psychosocial context and consequences of race: extent of black-white differences in the broad range of psychosocial factors assessed and the extent to which they contribute (independent of and in combination with SES) to racial differences in coronary calcification, diabetes, and hypertension. Williams and Network Psychosocial Group CC Wait till larger discussion of psychosocial variables. Look at: 1) extent W/B differences in psychosocial, what extent independent and interactions, 2) Differences in psychosocial and how contribute to health outcomes.
Race, age, and allostatic load: Is there an age patterning to the racial differences in allostatic load? That is, are markers of allostatic load evident at earlier ages for African Americans than for whites? Williams and Seeman UCLA On hold.
SES, allostatic load and mental health: The mediating role of cumulative risk. Evans, Seeman, Gruenewald, Matthews, Epel, Williams UCLA Analyses in progress.
Delineating subtypes of early family environments that confer physical and psychological risk. Saxby, Taylor, Seeman, Gruenewald, Kiefe UCLA Analyses in progress.
Biological correlates of social integration, social support and social conflict. Seeman, Gruenewald, Cohen UCLA Draft manuscript prepared.

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Unemployment and inflammation. Janicki-Deverts, Cohen, Matthews, Cullen CMU Published in 2008.
Influence of Race, Gender, and Marital Status on the Development of the Metabolic Syndrome Kiefer, Adler, Matthews UCSF Analyses in progress.
Racial differences in blood pressure trajectory in a biracial cohort: The CARDIA study. Schwartz, Ogedegbe, Williams, Cohen, Matthews Stony Brook Analyses in progress.

2. Whitehall II

This longitudinal study of 10,308 British civil servants, initiated in 1985, has been central to our ongoing integrative studies. It offers a unique opportunity for studying the relationship between SES and health in an occupationally based population. Respondents span the range of employment grades from office support to permanent secretary, with a 20-fold salary range. They have been well-characterized in terms of social position: economic/material (personal income, household income, wealth), occupational (employment grade), educational (years of education; qualification obtained), and parental social class. Measures of health, lifestyle, work characteristics, social support and life events have been repeatedly obtained over 22 years. With an increasingly large population of older citizens in the UK the Whitehall team seeks: (1) to determine the degree to which occurrence of cardiovascular disease and social inequalities at older age are produced by contemporaneous circumstances and by prior cumulative exposures to risk factors during working life, (2) to test the hypothesis that the functional consequences of living with increased cardiovascular risk in later life are modifiable, and (3) to understand social differences in the progression of cardiovascular risk based on longitudinal analysis of repeated measures.

During the course of our collaboration with the Whitehall team we have intellectually and financially supported a number of young researchers, including Meena Kumari, Tarani Chandola, Archana Singh-Manoux, and Mai Stafford. Many publications have resulted from this collaboration. Having both the CARDIA and Whitehall samples has allowed for comparison analyses, for example, a paper comparing the association between subjective socioeconomic status and health between different ethnic groups in Whitehall II and CARDIA was published in 2008 (Adler NE, Singh-Manoux A, Schwartz J, Stewart J, Matthews K, Marmot, MG. Social status and health: A comparison of British civil servants with European- and African- Americans). It replicates Whitehall analyses published in 2003 (Singh-Manoux A, Adler NE, Marmot M. Subjective social status: its determinants and its association with measures of ill-health in the Whitehall II study. Soc Sci Med 2003; 56:1321-33).

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3. Large industrial company

The Industry Study was initiated with Network support in 1998 by Mark Cullen. This study includes 25,000 employees of a large industrial company at 15 industrial plants scattered around the US; over 20% are non-white and over 25% are women. This rich data set includes complete demographics, work histories and work performance measures for all workers since 1985, continuous and complete health insurance and various physical status measures since 1996, and key information about physical and social characteristics of each job and each work location. Network support has allowed these data bases to be linked, making possible analyses of health effects of job categories and work conditions. Work proceeds looking at the role of physical and psychosocial characteristics of jobs and work locations as they predict physical injury, chronic disease, mental health outcomes, and disability. There is also an increased focus on utilization of care and quality as it may impact the relationship between SES and health.

In 2006 the study received funding from NIA for a five year project totaling 5.5 million dollars ("Disease, disability and death in an aging workforce") which will ensure the continued work on these issues. This is a good example of how an investment of network funds resulted in far greater support for a major research initiative. In addition, the richly linked database whose assemblage was funded by the network has allowed members of the team to obtain a number of smaller grants and awards, and has resulted in seven dissertations. Four collaborations with network members are of particular note: with core group member Ichiro Kawachi and post-doctoral fellow Jane Clougherty, a major multilevel analysis of the causes of chronic disease; with Sheldon Cohen and his colleagues, an analysis of the impact of job stress on risk for lung function lost longitudinally; with Joe Schwartz, an assessment of the predictive value of the externally rated job demand survey versus the Karasek quality of employment survey on injury risk; and with Michael Marmot, a comparison of the externally rated job demand survey in Whitehall and this company's populations.

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