Lifestyle factors as mediators of area-level socio-economic differentials in cardiovascular disease risk factors. The Tromso Study
Introduction: Cardiovascular disease (CVD) is a leading cause of death and disability and living in areas with low socio-economic status (SES) is associated with increased risk of CVD. Lifestyle factors such as smoking, physical inactivity, an unhealthy diet and harmful alcohol use are main risk fac...
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Elsevier Ltd.
2022
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Online Access: | https://acuresearchbank.acu.edu.au/download/2b5c3a36acfb1813ca541c77a34e4b9f3b20418965e1308f9f654e3a729a11de/732238/OA_Cerin_2022_Lifestyle_factors_as_mediators_of_area-level.pdf https://doi.org/10.1016/j.ssmph.2022.101241 |
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ftaustraliancuni:oai:acuresearchbank.acu.edu.au:8y924 2023-09-05T13:23:45+02:00 Lifestyle factors as mediators of area-level socio-economic differentials in cardiovascular disease risk factors. The Tromso Study Tiwari, Sweta Cerin, Ester Wilsgaard, Tom Løvsletten, Ola Njølstad, Inger Grimsgaard, Sameline Hopstock, Laila Schirmer, Henrik Rosengren, Annika Kristoffersen, Kathrin Loechen, Maja-Lisa 01 Jan 2022 application/pdf https://acuresearchbank.acu.edu.au/download/2b5c3a36acfb1813ca541c77a34e4b9f3b20418965e1308f9f654e3a729a11de/732238/OA_Cerin_2022_Lifestyle_factors_as_mediators_of_area-level.pdf https://doi.org/10.1016/j.ssmph.2022.101241 unknown Elsevier Ltd. https://acuresearchbank.acu.edu.au/item/8y924/lifestyle-factors-as-mediators-of-area-level-socio-economic-differentials-in-cardiovascular-disease-risk-factors-the-tromso-study ISSN:2352-8273 https://acuresearchbank.acu.edu.au/download/2b5c3a36acfb1813ca541c77a34e4b9f3b20418965e1308f9f654e3a729a11de/732238/OA_Cerin_2022_Lifestyle_factors_as_mediators_of_area-level.pdf https://doi.org/10.1016/j.ssmph.2022.101241 Tiwari, Sweta, Cerin, Ester, Wilsgaard, Tom, Løvsletten, Ola, Njølstad, Inger, Grimsgaard, Sameline, Hopstock, Laila, Schirmer, Henrik, Rosengren, Annika, Kristoffersen, Kathrin and Loechen, Maja-Lisa. (2022). Lifestyle factors as mediators of area-level socio-economic differentials in cardiovascular disease risk factors. The Tromso Study. Social Science and Medicine – Population Health. 19, pp. 1-13. https://doi.org/10.1016/j.ssmph.2022.101241 CC BY 4.0 Area level socio-economic status Cardiovascular disease Risk factors Mediation journal-article PeerReviewed 2022 ftaustraliancuni https://doi.org/10.1016/j.ssmph.2022.101241 2023-08-11T14:03:39Z Introduction: Cardiovascular disease (CVD) is a leading cause of death and disability and living in areas with low socio-economic status (SES) is associated with increased risk of CVD. Lifestyle factors such as smoking, physical inactivity, an unhealthy diet and harmful alcohol use are main risk factors that contribute to other modifiable risk factors, such as hypertension, raised blood cholesterol, obesity, and diabetes. The potential impact of area-level socio-economic status (ASES) on metabolic CVD risk factors via lifestyle behaviors independent of individual SES has not been investigated previously. Aims: To estimate associations of ASES with CVD risk factors and the mediating role of lifestyle behaviors independent of individual-level SES. Methods: In this cross-sectional study, we included 19,415 participants (52% women) from the seventh survey of the Tromsø Study (2015–2016) (Tromsø7). The exposure variable ASES was created by aggregating individual-level SES variables (education, income, housing ownership) at the geographical subdivision level. Individual-level SES data and geographical subdivision of Tromsø municipality (36 areas) were obtained from Statistics Norway. Variables from questionnaires and clinical examinations obtained from Tromsø7 were used as mediators (smoking, snuff, alcohol, and physical activity), while the outcome variables were body mass index (BMI), total/high-density lipoprotein (HDL) cholesterol ratio, waist circumference, hypertension, diabetes. Mediation and mediated moderation analysis were performed with age as a moderator, stratified by sex. Results: ASES was significantly associated with all outcome variables. CVD risk factor level declined with an increase in ASES. These associations were mediated by differences in smoking habits, alcohol use and physical activity. The associations of ASES with total/HDL cholesterol ratio and waist circumference (women) were moderated by age, and the moderating effects were mediated by smoking and physical activity in both sexes. The ... Article in Journal/Newspaper Tromso Tromso Tromsø Australian Catholic University: ACU Research Bank Norway Tromso ENVELOPE(16.546,16.546,68.801,68.801) Tromsø SSM - Population Health 19 101241 |
institution |
Open Polar |
collection |
Australian Catholic University: ACU Research Bank |
op_collection_id |
ftaustraliancuni |
language |
unknown |
topic |
Area level socio-economic status Cardiovascular disease Risk factors Mediation |
spellingShingle |
Area level socio-economic status Cardiovascular disease Risk factors Mediation Tiwari, Sweta Cerin, Ester Wilsgaard, Tom Løvsletten, Ola Njølstad, Inger Grimsgaard, Sameline Hopstock, Laila Schirmer, Henrik Rosengren, Annika Kristoffersen, Kathrin Loechen, Maja-Lisa Lifestyle factors as mediators of area-level socio-economic differentials in cardiovascular disease risk factors. The Tromso Study |
topic_facet |
Area level socio-economic status Cardiovascular disease Risk factors Mediation |
description |
Introduction: Cardiovascular disease (CVD) is a leading cause of death and disability and living in areas with low socio-economic status (SES) is associated with increased risk of CVD. Lifestyle factors such as smoking, physical inactivity, an unhealthy diet and harmful alcohol use are main risk factors that contribute to other modifiable risk factors, such as hypertension, raised blood cholesterol, obesity, and diabetes. The potential impact of area-level socio-economic status (ASES) on metabolic CVD risk factors via lifestyle behaviors independent of individual SES has not been investigated previously. Aims: To estimate associations of ASES with CVD risk factors and the mediating role of lifestyle behaviors independent of individual-level SES. Methods: In this cross-sectional study, we included 19,415 participants (52% women) from the seventh survey of the Tromsø Study (2015–2016) (Tromsø7). The exposure variable ASES was created by aggregating individual-level SES variables (education, income, housing ownership) at the geographical subdivision level. Individual-level SES data and geographical subdivision of Tromsø municipality (36 areas) were obtained from Statistics Norway. Variables from questionnaires and clinical examinations obtained from Tromsø7 were used as mediators (smoking, snuff, alcohol, and physical activity), while the outcome variables were body mass index (BMI), total/high-density lipoprotein (HDL) cholesterol ratio, waist circumference, hypertension, diabetes. Mediation and mediated moderation analysis were performed with age as a moderator, stratified by sex. Results: ASES was significantly associated with all outcome variables. CVD risk factor level declined with an increase in ASES. These associations were mediated by differences in smoking habits, alcohol use and physical activity. The associations of ASES with total/HDL cholesterol ratio and waist circumference (women) were moderated by age, and the moderating effects were mediated by smoking and physical activity in both sexes. The ... |
format |
Article in Journal/Newspaper |
author |
Tiwari, Sweta Cerin, Ester Wilsgaard, Tom Løvsletten, Ola Njølstad, Inger Grimsgaard, Sameline Hopstock, Laila Schirmer, Henrik Rosengren, Annika Kristoffersen, Kathrin Loechen, Maja-Lisa |
author_facet |
Tiwari, Sweta Cerin, Ester Wilsgaard, Tom Løvsletten, Ola Njølstad, Inger Grimsgaard, Sameline Hopstock, Laila Schirmer, Henrik Rosengren, Annika Kristoffersen, Kathrin Loechen, Maja-Lisa |
author_sort |
Tiwari, Sweta |
title |
Lifestyle factors as mediators of area-level socio-economic differentials in cardiovascular disease risk factors. The Tromso Study |
title_short |
Lifestyle factors as mediators of area-level socio-economic differentials in cardiovascular disease risk factors. The Tromso Study |
title_full |
Lifestyle factors as mediators of area-level socio-economic differentials in cardiovascular disease risk factors. The Tromso Study |
title_fullStr |
Lifestyle factors as mediators of area-level socio-economic differentials in cardiovascular disease risk factors. The Tromso Study |
title_full_unstemmed |
Lifestyle factors as mediators of area-level socio-economic differentials in cardiovascular disease risk factors. The Tromso Study |
title_sort |
lifestyle factors as mediators of area-level socio-economic differentials in cardiovascular disease risk factors. the tromso study |
publisher |
Elsevier Ltd. |
publishDate |
2022 |
url |
https://acuresearchbank.acu.edu.au/download/2b5c3a36acfb1813ca541c77a34e4b9f3b20418965e1308f9f654e3a729a11de/732238/OA_Cerin_2022_Lifestyle_factors_as_mediators_of_area-level.pdf https://doi.org/10.1016/j.ssmph.2022.101241 |
long_lat |
ENVELOPE(16.546,16.546,68.801,68.801) |
geographic |
Norway Tromso Tromsø |
geographic_facet |
Norway Tromso Tromsø |
genre |
Tromso Tromso Tromsø |
genre_facet |
Tromso Tromso Tromsø |
op_relation |
https://acuresearchbank.acu.edu.au/item/8y924/lifestyle-factors-as-mediators-of-area-level-socio-economic-differentials-in-cardiovascular-disease-risk-factors-the-tromso-study ISSN:2352-8273 https://acuresearchbank.acu.edu.au/download/2b5c3a36acfb1813ca541c77a34e4b9f3b20418965e1308f9f654e3a729a11de/732238/OA_Cerin_2022_Lifestyle_factors_as_mediators_of_area-level.pdf https://doi.org/10.1016/j.ssmph.2022.101241 Tiwari, Sweta, Cerin, Ester, Wilsgaard, Tom, Løvsletten, Ola, Njølstad, Inger, Grimsgaard, Sameline, Hopstock, Laila, Schirmer, Henrik, Rosengren, Annika, Kristoffersen, Kathrin and Loechen, Maja-Lisa. (2022). Lifestyle factors as mediators of area-level socio-economic differentials in cardiovascular disease risk factors. The Tromso Study. Social Science and Medicine – Population Health. 19, pp. 1-13. https://doi.org/10.1016/j.ssmph.2022.101241 |
op_rights |
CC BY 4.0 |
op_doi |
https://doi.org/10.1016/j.ssmph.2022.101241 |
container_title |
SSM - Population Health |
container_volume |
19 |
container_start_page |
101241 |
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1776204338790662144 |