eprintid: 26188
rev_number: 13
eprint_status: archive
userid: 1589
dir: disk0/00/02/61/88
datestamp: 2019-05-22 15:08:09
lastmod: 2024-03-09 11:12:46
status_changed: 2019-05-22 15:08:09
type: article
metadata_visibility: show
creators_name: Grau, Armin J.
creators_name: Aigner, Annette
creators_name: Urbanek, Christian
creators_name: Palm, Frederik
creators_name: Buggle, Florian
creators_name: Safer, Anton
creators_name: Becher, Heiko
title: Socioeconomic decline and advancement within and between generations and the risk of stroke - a case-control study
subjects: 610
divisions: 912800
keywords: Socioeconomic conditions, Risk factor, Ischemic stroke
abstract: Background: Disadvantageous socioeconomic conditions (SEC) in both childhood and adulthood increase the risk of stroke. We investigated whether intergenerational and lifetime social advancement decreases and/or social descent increases stroke risk.

Methods: In a case-control study with 466 patients with first-ever ischemic stroke and 807 controls randomly selected from the general population, we compared paternal profession to subjects’ professional education in adolescence and their last profession in adulthood. Furthermore, we constructed a socioeconomic risk score for childhood (based on paternal and maternal profession and occupation, familial, living and material conditions), adolescence (based on highest school degree and professional education), and adulthood (based on last profession, periods of unemployment, and marital status), and compared subjects´ positions at different life stages. Odds ratios were derived based on conditional logistic regression conditioning on age and sex only, after adjustment for medical and lifestyle risk factors, and after additional adjustment for socioeconomic risk score values.

Results: Intergenerational upward mobility between paternal profession and subject’s professional education was associated with lower ischemic stroke risk independent of medical and lifestyle risk factors (odds ratio (OR) 0.58; 95% confidence interval (CI) 0.41–0.81) and after additional adjustment for socioeconomic conditions in all three life stages (OR 0.67; 95% CI 0.45–0.99). Advancement between fathers´ profession and subject’s last profession was associated with reduced odds of stroke after adjustment for risk factors (OR 0.65; 95% CI 0.47–0.89), but not significantly after additional adjustment for SEC (OR 0.77; 95% CI 0.52–1.13). Social descent between adolescence and adulthood indicated by the transition into a more disadvantageous tertile of socioeconomic risk score was associated with increased odds of stroke after adjustment for all risk factor (OR 2.93; 95% CI 1.21–7.13). Analyses by sex revealed mostly similar results in men and women with only few potential differences.

Conclusions: Our study results indicate that aspects of social downward mobility during adulthood may be associated with increased risk of stroke, whereas intergenerational upward mobility may be linked to a lower stroke risk. If confirmed by future studies, such results may help to focus stroke prevention measures at high risk populations.
date: 2019
publisher: BioMed Central
id_scheme: DOI
ppn_swb: 1666512362
own_urn: urn:nbn:de:bsz:16-heidok-261881
language: eng
bibsort: GRAUARMINJSOCIOECONO2019
full_text_status: public
publication: Neurological Research and Practice
volume: 1
number: 8
place_of_pub: London
pagerange: 1-6
issn: 2524-3489
citation:   Grau, Armin J. ; Aigner, Annette ; Urbanek, Christian ; Palm, Frederik ; Buggle, Florian ; Safer, Anton ; Becher, Heiko  (2019) Socioeconomic decline and advancement within and between generations and the risk of stroke - a case-control study.  Neurological Research and Practice, 1 (8).  pp. 1-6.  ISSN 2524-3489     
document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/26188/1/42466_2019_Article_12.pdf