Journal of Public Health Advance Access originally published online on September 9, 2005
Journal of Public Health 2005 27(4):378-387; doi:10.1093/pubmed/fdi052
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A comparison of the association between socioeconomic position and cardiovascular disease risk factors in three age cohorts of Australian women: findings from the Australian Longitudinal Study on Women’s Health
Debbie A. Lawlor
Debbie A. Lawlor, Senior Lecturer in Epidemiology & Public Health Medicine, Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK
Leigh Tooth
Leigh Tooth, Post Doctoral Research Fellow, School of Population Health, University of Queensland, Brisbane, Queensland 4072, Australia
Christina Lee
Christina Lee, Professor, School of Population Health, University of Queensland, Brisbane, Queensland 4072, Australia; School of Psychology, University of Queensland, Brisbane, Queensland 4072, Australia
Annette Dobson
Annette Dobson, Professor, School of Population Health, University of Queensland, Brisbane, Queensland 4072, Australia
Address correspondence to Debbie A. Lawlor. Email: d.a.lawlor{at}bristol.ac.uk
Objectives To assess the associations between three measurements of socioeconomic position (SEP) – education, occupation and ability to cope on available income – and cardiovascular risk factors in three age cohorts of Australian women.
Methods Cross-sectional analysis of three cohorts of Australian women aged 18–23, 45–50 and 70–75 years.
Results In general, for all exposures and in all three cohorts, the odds of each adverse risk factor (smoking, obesity and physical inactivity) were lower in the most advantaged compared with the least advantaged. Within each of the three cohorts, the effects of each measurement of SEP on the outcomes were similar. There were, however, some notable between-cohort differences. The most marked differences were those with smoking. For women aged 70–75 (older), those with the highest educational attainment were more likely to have ever smoked than those with the lowest level of attainment. However, for the other two cohorts, this association was reversed, with a stronger association between low levels of education and ever smoking among those aged 18–23 (younger) than those aged 45–50 (mid-age). Similarly, for older women, those in the most skilled occupational classes were most likely to have ever smoked, with opposite findings for mid-age women. Education was also differently associated with physical inactivity across the three cohorts. Older women who were most educated were least likely to be physically inactive, whereas among the younger and mid-age cohorts there was little or no effect of education on physical inactivity.
Conclusion These findings demonstrate the dynamic nature of the association between SEP and some health outcomes. Our findings do not appear to confirm previous suggestions that prestige-based measurements of SEP are more strongly associated with health-related behaviours than measurements that reflect material and psychosocial resources.
Keywords: cardiovascular disease, risk factors, socioeconomic position, women