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dc.contributor.authorClark, Cheryl
dc.contributor.authorRidker, Paul M.
dc.contributor.authorOmmerborn, Mark J
dc.contributor.authorHuisingh, Carrie E
dc.contributor.authorCoull, Brent Andrew
dc.contributor.authorBuring, Julie Elizabeth
dc.contributor.authorBerkman, Lisa Faye
dc.date.accessioned2012-10-26T16:34:05Z
dc.date.issued2012
dc.identifier.citationClark, Cheryl R., Paul M. Ridker, Mark J. Ommerborn, Carrie E. Huisingh, Brent Coull, Julie E. Buring, and Lisa F. Berkman. 2012. Cardiovascular inflammation in healthy women: Multilevel associations with state-level prosperity, productivity and income inequality. BMC Public Health 12: 211.en_US
dc.identifier.issn1471-2458en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:9809466
dc.description.abstractBackground: Cardiovascular inflammation is a key contributor to the development of atherosclerosis and the prediction of cardiovascular events among healthy women. An emerging literature suggests biomarkers of inflammation vary by geography of residence at the state-level, and are associated with individual-level socioeconomic status. Associations between cardiovascular inflammation and state-level socioeconomic conditions have not been evaluated. The study objective is to estimate whether there are independent associations between state-level socioeconomic conditions and individual-level biomarkers of inflammation, in excess of individual-level income and clinical covariates among healthy women. Methods: The authors examined cross-sectional multilevel associations among state-level socioeconomic conditions, individual-level income, and biomarkers of inflammation among women (n = 26,029) in the Women's Health Study, a nation-wide cohort of healthy women free of cardiovascular diseases at enrollment. High sensitivity C-reactive protein (hsCRP), soluble intercellular adhesion molecule-1 (sICAM-1) and fibrinogen were measured between 1993 and 1996. Biomarker levels were examined among women within quartiles of state-level socioeconomic conditions and within categories of individual-level income. Results: The authors found that favorable state-level socioeconomic conditions were correlated with lower hsCRP, in excess of individual-level income (e.g. state-level real per capital gross domestic product fixed effect standardized Βeta coefficient [Std B] -0.03, 95% CI -0.05, -0.004). Individual-level income was more closely associated with sICAM-1 (Std B -0.04, 95% CI -0.06, -0.03) and fibrinogen (Std B -0.05, 95% CI -0.06, -0.03) than state-level conditions. Conclusions: We found associations between state-level socioeconomic conditions and hsCRP among healthy women. Personal household income was more closely associated with sICAM-1 and fibrinogen than state-level socioeconomic conditions. Additional research should examine these associations in other cohorts, and investigate what more-advantaged states do differently than less-advantaged states that may influence levels of cardiovascular inflammation among healthy women.en_US
dc.language.isoen_USen_US
dc.publisherBioMed Centralen_US
dc.relation.isversionofdoi:10.1186/1471-2458-12-211en_US
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3323890/pdf/en_US
dash.licenseLAA
dc.subjectc-reactive proteinen_US
dc.subjectgeographyen_US
dc.subjectincomeen_US
dc.subjectinflammationen_US
dc.subjectmultilevel analysisen_US
dc.subjectpovertyen_US
dc.subjectsocioeconomic factorsen_US
dc.subjectwomen’s healthen_US
dc.titleCardiovascular Inflammation in Healthy Women: Multilevel Associations with State-Level Prosperity, Productivity and Income Inequalityen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalBMC Public Healthen_US
dash.depositing.authorClark, Cheryl
dc.date.available2012-10-26T16:34:05Z
dc.identifier.doi10.1186/1471-2458-12-211*
dash.contributor.affiliatedClark, Cheryl
dash.contributor.affiliatedBerkman, Lisa
dash.contributor.affiliatedRidker, Paul
dash.contributor.affiliatedBuring, Julie
dash.contributor.affiliatedCoull, Brent


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