Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/22843
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dc.contributor.authorRobertson, Tonyen_UK
dc.contributor.authorWatts, Eleanoren_UK
dc.date.accessioned2016-03-04T23:53:07Z-
dc.date.available2016-03-04T23:53:07Z-
dc.date.issued2016-02-09en_UK
dc.identifier.other126en_UK
dc.identifier.urihttp://hdl.handle.net/1893/22843-
dc.description.abstractBackground  Given the broad spectrum of health and wellbeing outcomes that are patterned by socioeconomic position (SEP), it has been suggested that there may be common biological pathways linking SEP and health. Allostatic load is one such pathway, which aims to measure cumulative burden/dysregulation across multiple physiological systems. This study aimed to determine the contextual and demographic factors (age, sex and place) that may be important in better understanding the links between lower SEP and higher allostatic load.  Methods  Data were from a nationally representative sample of adults (18+): the Scottish Health Survey (2008–2011). Higher SEP (‘1’) was defined as having ‘Higher’-level, secondary school qualifications versus having lower level or no qualifications (‘0’). For allostatic load, a range of 10 biomarkers across the cardiovascular, metabolic and immune systems were used. Respondents were scored “1” for each biomarker that fell into the highest quartile of risk. Linear regressions were run in STATA, including SEP, age (continuous and as a 7-category variable), sex (male/female), urbanity (a 5-category variable ranging from primary cities to remote rural areas) and geographical location (based on 10 area-level healthboards). Interactions between SEP and each predictor, as well as stratified analyses, were tested.  Results  Lower SEP was associated with higher allostatic load even after adjusting for age, sex and place (b = −0.631, 95% CI −0.795, −0.389,p < 0.001). There was no significant effect moderation between SEP and age, sex or place. Stratified analysis did show that the inequality identified in the baseline models widened with age, becoming significant at ages 35–44, before narrowing at older ages (75+). There was no difference by sex, but more mixed findings with regards place (urbanity or geographical location), with a mix of significant and non-significant results by SEP that did not appear to follow any pattern.  Conclusions  Inequalities in allostatic load by educational attainment, as a measure of SEP, are consistent with age, sex and place. However, these stratified analyses showed that these inequalities did widen with age, before narrowing in later life, matching the patterns seen with other objective and subjective health measures. However, effect moderation analysis did not support evidence of a statistically significant interaction between age and SEP. Context remains an important feature in understanding and potentially addressing inequalities, although may be less of an issue in terms of physiological burden.en_UK
dc.language.isoenen_UK
dc.publisherBioMed Centralen_UK
dc.relationRobertson T & Watts E (2016) The importance of age, sex and place in understanding socioeconomic inequalities in allostatic load: Evidence from the Scottish Health Survey (2008–2011). BMC Public Health, 16 (1), Art. No.: 126. https://doi.org/10.1186/s12889-016-2796-4en_UK
dc.rightsThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://​creativecommons.​org/​licenses/​by/​4.​0/​), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://​creativecommons.​org/​publicdomain/​zero/​1.​0/​) applies to the data made available in this article, unless otherwise stated.en_UK
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_UK
dc.subjectallostatic loaden_UK
dc.subjectsocioeconomic positionen_UK
dc.subjecteducationen_UK
dc.subjecthealth inequalitiesen_UK
dc.titleThe importance of age, sex and place in understanding socioeconomic inequalities in allostatic load: Evidence from the Scottish Health Survey (2008–2011)en_UK
dc.typeJournal Articleen_UK
dc.identifier.doi10.1186/s12889-016-2796-4en_UK
dc.identifier.pmid26856976en_UK
dc.citation.jtitleBMC Public Healthen_UK
dc.citation.issn1471-2458en_UK
dc.citation.volume16en_UK
dc.citation.issue1en_UK
dc.citation.publicationstatusPublisheden_UK
dc.citation.peerreviewedRefereeden_UK
dc.type.statusVoR - Version of Recorden_UK
dc.author.emailtony.robertson@stir.ac.uken_UK
dc.citation.date09/02/2016en_UK
dc.contributor.affiliationHS - Management and Support - LEGACYen_UK
dc.contributor.affiliationUniversity of Oxforden_UK
dc.identifier.isiWOS:000369808300001en_UK
dc.identifier.scopusid2-s2.0-84956886965en_UK
dc.identifier.wtid578970en_UK
dc.contributor.orcid0000-0002-1962-5874en_UK
dc.date.accepted2016-02-01en_UK
dcterms.dateAccepted2016-02-01en_UK
dc.date.filedepositdate2016-02-17en_UK
rioxxterms.apcpaiden_UK
rioxxterms.typeJournal Article/Reviewen_UK
rioxxterms.versionVoRen_UK
local.rioxx.authorRobertson, Tony|0000-0002-1962-5874en_UK
local.rioxx.authorWatts, Eleanor|en_UK
local.rioxx.projectInternal Project|University of Stirling|https://isni.org/isni/0000000122484331en_UK
local.rioxx.freetoreaddate2016-02-17en_UK
local.rioxx.licencehttp://creativecommons.org/licenses/by/4.0/|2016-02-17|en_UK
local.rioxx.filenamerobertson (2016) BMC PH - context.pdfen_UK
local.rioxx.filecount1en_UK
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