Life course socioeconomic status and longitudinal accumulation of allostatic load in adulthood: multi-ethnic study of atherosclerosis.

Abstract

We examined the association of childhood and adult socioeconomic status with longitudinal change in allostatic load (AL), a measure of biological dysfunction. The study sample included 6135 participants from the Multi-Ethnic Study of Atherosclerosis, aged 45 to 84 years, recruited in 2000 from 6 US counties; 3 follow-up examinations took place through September 2011. We calculated standardized scores for several metabolic and cardiovascular components relative to accepted clinical cut points for "higher risk" and then summed them to create an overall index of AL. We used mixed effects growth curve models to assess the relationship between socioeconomic status and AL as a linear function of time passed since the baseline examination; we included random effects for the intercept and slope. Among those with lower baseline AL (< median), high adult education was associated with a significantly slower increase in AL over time, whereas there was no significant association among those with higher baseline AL. The relationship between socioeconomic status and patterns of change in health parameters may vary over time and with the accumulation of biological risk.