Social Patterning of Cumulative Biological Risk by Education and Income Among African Americans

Objectives. We examined the social patterning of cumulative dysregulation of multiple systems, or allostatic load, among African Americans adults. Methods. We examined the cross-sectional associations of socioeconomic status (SES) with summary indices of allostatic load and neuroendocrine, metabolic, autonomic, and immune function components in 4048 Jackson Heart Study participants. Results. Lower education and income were associated with higher allostatic load scores in African American adults. Patterns were most consistent for the metabolic and immune dimensions, less consistent for the autonomic dimension, and absent for the neuroendocrine dimension among African American women. Associations of SES with the global allostatic load score and the metabolic and immune domains persisted after adjustment for behavioral factors and were stronger for income than for education. There was some evidence that the neuroendocrine dimension was inversely associated with SES after behavioral adjustment in men, but the immune and autonomic components did not show clear dose response trends, and we observed no associations for the metabolic component. Conclusions. Findings support our hypothesis that allostatic load is socially patterned in African American women, but this pattern is less consistent in African American men. (Am J Public Health. 2012;102:1362-1369. doi:10.2105/AJPH.2011.300444)