Pathways between childhood/adolescent adversity, adolescent socioeconomic status, and long-term cardiovascular disease risk in young adulthood

Jenalee R. Doom, Susan M. Mason, Shakira F. Suglia, Cari Jo Clark

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

Objective The current study investigated mediators between childhood/adolescent adversities (e.g., dating violence, maltreatment, homelessness, and parental death), low socioeconomic status (SES) during adolescence, and cardiovascular disease (CVD) risk in young adulthood. The purpose of these analyses was to understand whether SES during adolescence and childhood/adolescent adversities affect CVD risk through similar pathways, including maternal relationship quality, health behaviors, financial stress, medical/dental care, educational attainment, sleep problems, and depressive symptoms. Methods Using the National Longitudinal Study of Adolescent to Adult Health (N = 14,493), which has followed US adolescents (Wave 1; M = 15.9 years) through early adulthood (Wave 4; M = 28.9 years), associations were examined between childhood/adolescent adversity and SES to 30-year CVD risk in young adulthood. The outcome was a Framingham-based prediction model of CVD risk that included age, sex, body mass index, smoking, systolic blood pressure, diabetes, and antihypertensive medication use at Wave 4. Path analysis was used to examine paths through the adolescent maternal relationship to young adult mediators of CVD risk. Results Childhood/adolescent adversity significantly predicted greater adult CVD risk through the following pathways: maternal relationship, health behaviors, financial stress, lack of medical/dental care, and educational attainment; but not through depressive symptoms or sleep problems. Lower SES during adolescence significantly predicted greater adult CVD risk through the following pathways: health behaviors, financial stress, lack of medical/dental care, and educational attainment, but not maternal relationship, depressive symptoms, or sleep problems. Conclusions Childhood/adolescent adversities and SES affected CVD risk in young adulthood through both similar and unique pathways that may inform interventions.

Original languageEnglish (US)
Pages (from-to)166-175
Number of pages10
JournalSocial Science and Medicine
Volume188
DOIs
StatePublished - Sep 2017

Bibliographical note

Funding Information:
This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill. This program was funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website (http://www.cpc.unc.edu/addhealth). No direct support was received from grant P01-HD31921 for this analysis. A University of Minnesota Doctoral Dissertation Fellowship, a National Institute of Diabetes and Digestive and Kidney Diseases NRSA (2T32DK071212-11, Delia Vazquez, PI), and a Eunice Kennedy Shriver National Institute of Child Health and Human Development National Research Service Award (F32HD088029, PI: Doom) supported Jenalee Doom. The authors thank Dr. Megan Gunnar for her comments on this manuscript.

Publisher Copyright:
© 2017 Elsevier Ltd

Keywords

  • Add Health
  • Adolescence
  • Adversity
  • CVD
  • Socioeconomic status
  • United States
  • Young adulthood

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