TY - JOUR
T1 - Education and inequalities in risk scores for coronary heart disease and body mass index
T2 - Evidence for a population strategy
AU - Liu, Sze Yan
AU - Kawachi, Ichiro
AU - Glymour, M. Maria
PY - 2012/9
Y1 - 2012/9
N2 - BACKGROUND:: Concerns have been raised that education may have greater benefits for persons at high risk of coronary heart disease (CHD) than for those at low risk. METHODS:: We estimated the association of education (less than high school, high school, or college graduates) with 10-year CHD risk and body mass index (BMI), using linear and quantile regression models, in the following two nationally representative datasets: the 2006 wave of the Health and Retirement Survey and the 2003-2008 National Health and Nutrition Examination Survey (NHANES). RESULTS:: Higher educational attainment was associated with lower 10-year CHD risk for all groups. However, the magnitude of this association varied considerably across quantiles for some subgroups. For example, among women in NHANES, a high school degree was associated with 4% (95% confidence interval =-9% to 1%) and 17% (-24% to-8%) lower CHD risk in the 10th and 90th percentiles, respectively. For BMI, a college degree was associated with uniform decreases across the distribution for women, but with varying increases for men. Compared with those who had not completed high school, male college graduates in the NHANES sample had a BMI that was 6% greater (2% to 11%) at the 10th percentile of the BMI distribution and 7% lower (-10% to-3%) at the 90th percentile (ie, overweight/obese). Estimates from the Health and Retirement Survey sample and the marginal quantile regression models showed similar patterns. CONCLUSION:: Conventional regression methods may mask important variations in the associations between education and CHD risk.
AB - BACKGROUND:: Concerns have been raised that education may have greater benefits for persons at high risk of coronary heart disease (CHD) than for those at low risk. METHODS:: We estimated the association of education (less than high school, high school, or college graduates) with 10-year CHD risk and body mass index (BMI), using linear and quantile regression models, in the following two nationally representative datasets: the 2006 wave of the Health and Retirement Survey and the 2003-2008 National Health and Nutrition Examination Survey (NHANES). RESULTS:: Higher educational attainment was associated with lower 10-year CHD risk for all groups. However, the magnitude of this association varied considerably across quantiles for some subgroups. For example, among women in NHANES, a high school degree was associated with 4% (95% confidence interval =-9% to 1%) and 17% (-24% to-8%) lower CHD risk in the 10th and 90th percentiles, respectively. For BMI, a college degree was associated with uniform decreases across the distribution for women, but with varying increases for men. Compared with those who had not completed high school, male college graduates in the NHANES sample had a BMI that was 6% greater (2% to 11%) at the 10th percentile of the BMI distribution and 7% lower (-10% to-3%) at the 90th percentile (ie, overweight/obese). Estimates from the Health and Retirement Survey sample and the marginal quantile regression models showed similar patterns. CONCLUSION:: Conventional regression methods may mask important variations in the associations between education and CHD risk.
UR - http://www.scopus.com/inward/record.url?scp=84864871675&partnerID=8YFLogxK
U2 - 10.1097/EDE.0b013e318261c7cc
DO - 10.1097/EDE.0b013e318261c7cc
M3 - Article
C2 - 22814529
AN - SCOPUS:84864871675
SN - 1044-3983
VL - 23
SP - 657
EP - 664
JO - Epidemiology
JF - Epidemiology
IS - 5
ER -