Abstract: This study examines the relationships between area-level socioeconomic position (SEP) and the prevalence and trajectories of metabolic syndrome (MetS) and the count of its constituents (i.e., disturbed glucose and insulin metabolism, abdominal obesity, dyslipidemia, and hypertension). A cohort of 4,056 men and women aged 18+ living in Adelaide, Australia was established in 2000–2003. MetS was ascertained at baseline, four and eight years via clinical examinations. Baseline area-level median household income, percentage of residents with a high school education, and unemployment rate were derived from the 2001 population Census. Three-level random-intercepts logistic and Poisson regression models were performed to estimate the standardized odds ratio (SOR), prevalence risk ratio (SRR), ratio of SORs/SRRs, and (95% confidence interval (CI)). Interaction between area- and individual-level SEP variables was also tested. The odds of having MetS and the count of its constituents increased over time. This increase did not vary according to baseline area-level SEP (ratios of SORs/SRRs ≈ 1; p ≥ 0.42). However, at baseline, after adjustment for individual SEP and health behaviours, median household income (inversely) and unemployment rate (positively) were significantly associated with MetS prevalence (SOR (95%CI) = 0.76 (0.63–0.90), and 1.48 (1.26–1.74), respectively), and the count of its constituents (SRR (95%CI) = 0.96 (0.93–0.99), and 1.06 (1.04–1.09), respectively). The inverse association with area-level education was statistically significant only in participants with less than post high school education (SOR (95%CI) = 0.58 (0.45–0.73), and SRR (95%CI) = 0.91 (0.88–0.94)). Area-level SEP does not predict an elevated trajectory to developing MetS or an elevated count of its constituents. However, at baseline, area-level SEP was inversely associated with prevalence of MetS and the count of its constituents, with the association of area-level education being modified by individual-level education. Population-level interventions for communities defined by area-level socioeconomic disadvantage are needed to reduce cardiometabolic risks.
Keywords: metabolic syndrome; trajectories; socioeconomic position; income; education; cohort study; residence characteristics
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Ngo, A.D.; Paquet, C.; Howard, N.J.; Coffee, N.T.; Taylor, A.W.; Adams, R.J.; Daniel, M. Area-Level Socioeconomic Characteristics, Prevalence and Trajectories of Cardiometabolic Risk. Int. J. Environ. Res. Public Health 2014, 11, 830-848.
Ngo AD, Paquet C, Howard NJ, Coffee NT, Taylor AW, Adams RJ, Daniel M. Area-Level Socioeconomic Characteristics, Prevalence and Trajectories of Cardiometabolic Risk. International Journal of Environmental Research and Public Health. 2014; 11(1):830-848.
Ngo, Anh D.; Paquet, Catherine; Howard, Natasha J.; Coffee, Neil T.; Taylor, Anne W.; Adams, Robert J.; Daniel, Mark. 2014. "Area-Level Socioeconomic Characteristics, Prevalence and Trajectories of Cardiometabolic Risk." Int. J. Environ. Res. Public Health 11, no. 1: 830-848.