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      Sex-Specific Associations Between Area-Level Poverty and Cardiometabolic Dysfunction Among US Adolescents

      research-article
      , PhD, MPH 1 , , ScD, MA 1 , 2 , 3 , 4
      Public Health Reports
      SAGE Publications
      poverty, adolescent health, cardiometabolic risk factors, socioeconomic status, environment

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          Abstract

          Objective:

          Cardiometabolic disease is the leading cause of mortality in the United States. Cardiometabolic function during adolescence predicts future cardiometabolic disease, yet few studies have examined early determinants of cardiometabolic function. Informed by evidence of sex differences in the prevalence and severity of cardiometabolic disorders and evidence of sexual dimorphism in the stress response, we examined sex differences in the association between living in poverty and cardiometabolic function during adolescence, a precursor of later cardiometabolic disorders.

          Methods:

          We linked data from 10 415 adolescents aged 12-19 in the National Health and Nutrition Examination Survey (1999-2012) with US Census–tract data on area-level poverty (percentage of the population living in poverty, grouped into quartiles). We parameterized cardiometabolic dysfunction by summing the z scores of 6 cardiometabolic biomarkers, grouped into quintiles. Hierarchical ordinal models estimated associations.

          Results:

          Compared with residents in low-poverty areas, residents in high-poverty areas had elevated odds of cardiometabolic dysfunction (highest quartile of poverty odds ratio [OR] = 1.27; 95% confidence interval [CI], 1.08-1.50). This association was more pronounced among boys than girls (highest quartile of poverty for boys: OR = 1.36; 95% CI, 1.10-1.70; highest quartile of poverty for girls: OR = 1.17; 95% CI, 0.94-1.47).

          Conclusion:

          Our study supports the existence of sex-specific associations. These results highlight the potential for community-based programs, such as housing assistance, to improve population health.

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          Author and article information

          Journal
          Public Health Rep
          Public Health Rep
          PHR
          spphr
          Public Health Reports
          SAGE Publications (Sage CA: Los Angeles, CA )
          0033-3549
          1468-2877
          14 November 2019
          Jan-Feb 2020
          : 135
          : 1
          : 47-55
          Affiliations
          [1 ]Department of Family Science, Maternal and Child Health Program, University of Maryland College Park, College Park, MD, USA
          [2 ]Department of Epidemiology and Biostatistics, University of Maryland College Park, College Park, MD, USA
          [3 ]Department of Epidemiology and Biostatistics, School of Public Health, Brown University, Providence, RI, USA
          [4 ]Department of Epidemiology and Biostatistics, School of Medicine, University of Maryland Baltimore, Baltimore, MD, USA
          Author notes
          [*]Edmond D. Shenassa, ScD, MA, University of Maryland College Park, Department of Family Science, Maternal and Child Health Program, 4200 Valley Dr, College Park, MD 20742, USA. Email: shenassa@ 123456umd.edu
          Article
          PMC7119245 PMC7119245 7119245 10.1177_0033354919884303
          10.1177/0033354919884303
          7119245
          31725345
          fd901f0d-cd11-41d6-8471-873d4eb72f8b
          © 2019, Association of Schools and Programs of Public Health
          Categories
          Research
          Custom metadata
          January/February 2020
          ts3

          socioeconomic status,adolescent health,environment,poverty,cardiometabolic risk factors

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