Subjective socioeconomic status predicts Framingham cardiovascular disease risk for whites, not blacks

Higher rates of cardiovascular disease (CVD) and its risk factors are well documented among those with objective indicators of lower socioeconomic status (SES), such as income, education, and occupation. However, relatively little is known about the relationship of subjective SES to CVD risk, particularly within different racial groups.

Subjective SES and Framingham 10-year CVD risk profile were examined in 1,722 socioeconomically diverse Black and White adults enrolled in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. The sample had a mean age of 47.7 years, was 57% female, 56% African American, and 39% living in poverty.

Subjective SES was associated with greater CVD risk after adjustment for poverty status, substance use, BMI, depression, antihypertensives, and co-morbidities (B = -.059, t[1,1711] = -2.44, P = .015). However, when the analysis was race-stratified, subjective SES was associated with CVD risk in Whites (B = -.074, F[1,787] = -2.01, P = .045), but not Blacks.

These results suggest that subjective SES may aid in predicting CVD risk in Whites, but not Blacks. It is important to note that these analyses were adjusted for poverty status, a potent indicator of objective SES. Thus, these findings further suggest that for Whites, subjective SES may influence CVD risk beyond that associated with objective SES. These findings highlight the potential importance of patients' subjective SES in CVD risk detection.