Life course socioeconomic adversities and 10-year risk of cardiovascular disease: cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health

Int J Public Health. 2017 Mar;62(2):283-292. doi: 10.1007/s00038-016-0928-3. Epub 2016 Dec 2.


Objectives: To investigate whether life course exposure to adverse socioeconomic positions (SEP) as well as maintaining a low SEP or decreasing the SEP intra- and intergeneration was associated with an increased 10-year cardiovascular disease (CVD) risk predicted by the Framingham Risk Score.

Methods: This is a cross-sectional analysis of baseline data (2008-2010) of 13,544 active workers from ELSA-Brasil cohort. Maternal education, leg length, social class of first occupation and education were used to evaluate childhood, youth and adulthood SEP.

Results: After considering adulthood SEP, exposure to early-life low SEP remained associated with an increased 10-year CVD risk. The 10-year CVD risk also rose as the number of exposures to low SEP throughout life increased. Compared to individuals in high-stable intragenerational trajectory, those in upward, downward, or stable low trajectory presented higher 10-year CVD risk. Increasing individuals' SEP over generation showed no increased risk of 10-year CVD risk compared to individuals in high-stable trajectory.

Conclusions: Childhood may be a critical period for exposures to social adversities. Life course low SEP may also affect the 10-year CVD risk via accumulation of risk and social mobility.

Keywords: Cardiovascular disease; Framingham Risk Score; Life course; Social mobility; Socioeconomic position.

MeSH terms

  • Adult
  • Adult Survivors of Child Adverse Events / statistics & numerical data*
  • Aged
  • Brazil / epidemiology
  • Cardiovascular Diseases / epidemiology*
  • Cross-Sectional Studies
  • Female
  • Health Status Disparities*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Risk Factors
  • Social Class*
  • Social Mobility