Association of Socioeconomic Status With Functional Capacity, Heart Rate Recovery, and All-Cause Mortality
JAMAPublished 14 February 2006
Mehdi H. Shishehbor
Citations148
SJR quartileQ1
SJR score5.35
SNIP10.71
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Impaired functional capacity and abnormal heart rate recovery were strongly associated with lower SES and accounted for a major proportion of the correlation between S ES and mortality.
Abstract
Impaired functional capacity and abnormal heart rate recovery were strongly associated with lower SES and accounted for a major proportion of the correlation between SES and mortality. Efforts to modify these clinical features among patients with low SES may narrow disparities in mortality.
Keywords
Medicine
Statistics in the health sciencesModeling Survival Data: Extending the Cox Model
8,662 Citations2000Terry M. Therneau, Patricia M. Grambsch
A Cox Model-based approach was used to estimate the Survival and Hazard Functions and the results confirmed the need for further investigation into the role of natural disasters in shaping survival rates.
Choice Reviews OnlineUnequal treatment: confronting racial and ethnic disparities in health care
7,044 Citations2003A. L. Nelson
A heating element includes an elongated tubular sheath which confines a resistance wire supported by a thermally conductive electrical insulation material which extends to a position flush with the end surface of the sheath.
PsycEXTRA DatasetPhysical Activity and Health: A Report of the Surgeon General
5,511 Citations1995
This report is the first report of the Surgeon General on physical activity and health, and strong evidence is shown to indicate that regular physical activity will provide clear and substantial health gains.
JAMAActual Causes of Death in the United States
5,351 Citations1993J. Michael McGinnis
The most prominent contributors to mortality in the United States in 1990 were tobacco, diet and activity patterns, alcohol, microbial agents, toxic agents, firearms, sexual behavior, motor vehicles, and illicit use of drugs.
New England Journal of MedicineExercise Capacity and Mortality among Men Referred for Exercise Testing
4,100 Citations2002Jonathan Myers, Manish Prakash +4 more
NatureThe inflammatory reflex
3,487 Citations2002Kevin J. Tracey
The discovery that cholinergic neurons inhibit acute inflammation has qualitatively expanded understanding of how the nervous system modulates immune responses, and the opportunity now exists to apply this insight to the treatment of inflammation through selective and reversible 'hard-wired' neural systems.
JAMAEvaluating the Yield of Medical Tests
3,442 Citations1982Frank E. Harrell
The treadmill exercise test is shown to provide surprisingly little prognostic information beyond that obtained from basic clinical measurements.
JAMASocioeconomic Status in Health Research
2,174 Citations2005Paula Braveman, Catherine Cubbin +5 more
Evidence shows that conclusions about nonsocioeconomic causes of racial/ethnic differences in health may depend on the measure-eg, income, wealth, education, occupation, neighborhood socioeconomic characteristics, or past socioeconomic experiences used to "control for SES," suggesting that findings from studies that have measured limited aspects of SES should be reassessed.
New England Journal of MedicineHeart-Rate Recovery Immediately after Exercise as a Predictor of Mortality
1,925 Citations1999Christopher R. Cole, Eugene H. Blackstone +3 more
A delayed decrease in the heart rate during the first minute after graded exercise, which may be a reflection of decreased vagal activity, is a powerful predictor of overall mortality, independent of workload, the presence or absence of myocardial perfusion defects, and changes inheart rate during exercise.
New England Journal of MedicineNeighborhood of Residence and Incidence of Coronary Heart Disease
1,786 Citations2001Ana V. Diez Roux, Sharon Stein Merkin +8 more
Even after controlling for personal income, education, and occupation, it is found that living in a disadvantaged neighborhood is associated with an increased incidence of coronary heart disease.
Journal of the American College of CardiologyACC/AHA guideline update for perioperative cardiovascular evaluation for noncardiac surgery—executive summary
1,690 Citations2002Kim A. Eagle, Peter B. Berger +21 more
American Journal of Public HealthOvercoming the absence of socioeconomic data in medical records: validation and application of a census-based methodology.
1,661 Citations1992Nancy Krieger
This census-based methodology offers a valid and useful approach to overcoming the absence of socioeconomic data in most US medical records.
JAMASocioeconomic Factors, Health Behaviors, and Mortality
1,515 Citations1998Paula M. Lantz, James S. House +4 more
Although reducing the prevalence of health risk behaviors in low-income populations is an important public health goal, socioeconomic differences in mortality are due to a wider array of factors and, therefore, would persist even with improved health behaviors among the disadvantaged.
JAMAInequality in Quality
1,169 Citations2000Kevin Fiscella, Peter Franks +2 more
5 principles to address disparities in health care through modifications in quality performance measures are proposed: disparities represent a significant quality problem and clinical performance measures should be stratified by race/ethnicity and socioeconomic position for public reporting.
American Journal of EpidemiologyGeocoding and Monitoring of US Socioeconomic Inequalities in Mortality and Cancer Incidence: Does the Choice of Area-based Measure and Geographic Level Matter?: The Public Health Disparities Geocoding Project
1,164 Citations2002Nancy Krieger
Diverse single-variable and composite area-based socioeconomic measures at the census tract, block group, and zip code level for Massachusetts and Rhode Island indicated that block group and tract socioeconomic measures performed comparably within and across both states, but zip code measures for several outcomes detected no gradients or gradients contrary to those observed with tract and block group measures.
ACC Current Journal ReviewSurgeon volume and operative mortality in the United States
1,116 Citations2004John D. Birkmeyer, Thérèse A. Stukel +4 more
Journal of the American College of CardiologyVagally mediated heart rate recovery after exercise is accelerated in athletes but blunted in patients with chronic heart failure
1,004 Citations1994Katsuji Imai, Hideyuki Sato +7 more
The results indicate that T30 is mediated primarily by vagal reactivation, independent of sympathetic withdrawal, and is significantly smaller in athletes and significantly larger in patients with chronic heart failure than that in respective age-matched normal control subjects.
CirculationExercise Capacity and the Risk of Death in Women
737 Citations2003Martha Gulati, Dilip K. Pandey +6 more
This study confirms that exercise capacity is an independent predictor of death in asymptomatic women, greater than what has been previously established among men.
American Journal of EpidemiologyPOVERTY AND HEALTH PROSPECTIVE EVIDENCE FROM THE ALAMEDA COUNTY STUDY
712 Citations1987Mary N. Haan, George A. Kaplan +1 more
JAMAHeart Rate Recovery and Treadmill Exercise Score as Predictors of Mortality in Patients Referred for Exercise ECG
705 Citations2000Erna Obenza Nishime
In this cohort of patients referred specifically for exercise electrocardiography, both abnormal heart rate recovery and treadmill exercise score were independent predictors of mortality.
New England Journal of MedicinePhysical Fitness as a Predictor of Cardiovascular Mortality in Asymptomatic North American Men
686 Citations1988Lars‐Göran Ekelund, William L. Haskell +4 more
It is concluded that a lower level of physical fitness is associated with a higher risk of death from coronary heart disease and cardiovascular disease in clinically healthy men, independent of conventional coronary risk factors.
ScienceCardiovascular Risk Factors Emerge After Artificial Selection for Low Aerobic Capacity
659 Citations2005Ulrik Wisløff, Sonia M. Najjar +9 more
After 11 generations, rats with low aerobic capacity scored high on cardiovascular risk factors that constitute the metabolic syndrome and the decrease in aerobic capacity was associated with decreases in the amounts of transcription factors required for mitochondrial biogenesis and in the amount of oxidative enzymes in skeletal muscle.
Journal of the American College of CardiologyCause of death in clinical research
595 Citations1999Michael S. Lauer, Eugene H. Blackstone +2 more
Clinical investigations of purported cardiac risk factors and new treatments focus on death as a primary end point and it is intuitively appealing to attempt to better understand the association.
Journal of Epidemiology & Community HealthIndividual social class, area-based deprivation, cardiovascular disease risk factors, and mortality: the Renfrew and Paisley Study.
545 Citations1998George Davey Smith, Carole Hart +3 more
Both the area-based deprivation indicator and individual social class were associated with generally less favourable profiles of cardiovascular disease risk factors at the time of the baseline screening examinations.
JAMAAccess to Medical Care for Black and White Americans
464 Citations1989Robert J. Blendon
Black Americans compared with whites are less likely to be satisfied with the qualitative ways their physicians treat them when they are ill, more dissatisfied with the care they receive when hospitalized, and more likely to believe that the duration of their hospitalizations is too short.
Journal of Health and Social BehaviorCommunity-Level Socioeconomic Status Effects on Adult Health
463 Citations1998Stéphanie Robert
This research suggests that improving individual-level and family-level socioeconomic circumstances may be the more direct way to improve the health of individuals, but that understanding the community context in which a person lives may also ultimately be important to improving health.
American Journal of EpidemiologyNeighborhood Social Environment and Risk of Death: Multilevel Evidence from the Alameda County Study
456 Citations1999Irene H. Yen, G. A. Kaplan
The role of area characteristics as a health risk factor is demonstrated and the need for more focused attention to the meaning and measurement of neighborhood quality is pointed to.
Arteriosclerosis Thrombosis and Vascular BiologyAssociations Between Cardiorespiratory Fitness and C-Reactive Protein in Men
380 Citations2002T.S. Church, C.E. Barlow +4 more
Cardiorespiratory fitness levels were inversely associated with C-reactive protein values and the prevalence of elevated CRP values in this sample of men from the Aerobics Center Longitudinal Study.
EpidemiologyMortality Effects of Community Socioeconomic Status
353 Citations1997Roger T. Anderson, Paul D. Sorlie +3 more
Although family income has a stronger association with mortality than census tract, area socioeconomic status makes a unique and substantial contribution to mortality and should be explored in health policy and disease prevention research.
Preventive MedicineCommunity-level comparisons between the grocery store environment and individual dietary practices
302 Citations1991Allen Cheadle, Bruce M. Psaty +5 more
Positive and statistically significant correlations were found at both the community and the zip code level between the availability of healthful products in stores and the reported healthfulness of individual diets.
ACC Current Journal ReviewExercise capacity and mortality among men referred for exercise testing
270 Citations2002Jonathan A. Myers, Mangire Ganesh Prakash +4 more
American Journal of Public HealthPhantom of the area: poverty-area residence and mortality in the United States.
266 Citations1998Norman J. Waitzman, Ken R. Smith
Residence in poverty areas contributes to socioeconomic gradients in mortality among nonelderly adults in the United States and is associated with significantly elevated risk of all-cause mortality.
Arteriosclerosis Thrombosis and Vascular BiologyFast Food, Central Nervous System Insulin Resistance, and Obesity
256 Citations2005Elvira Isganaitis, Robert H. Lustig
CirculationDoes Autonomic Function Link Social Position to Coronary Risk?
225 Citations2005Harry Hemingway, Martin J. Shipley +4 more
Chronically impaired autonomic function may link social position to different components of coronary risk in the general population.
HeartSocioeconomic status and ischaemic heart disease mortality in 10 western European populations during the 1990s
224 Citations2005Mauricio Avendaño, Anton E. Kunst +14 more
Socioeconomic disparities in IHD mortality were larger in northern than in southern European populations during the 1990s, which partly reflects the pattern of socioeconomic disparities in cardiovascular risk factors in Europe.
Journal of the American College of CardiologyImportance of Estimated Functional Capacity as a Predictor of All-Cause Mortality Among Patients Referred for Exercise Thallium Single-Photon Emission Computed Tomography: Report of 3,400 Patients From a Single Center
207 Citations1997Claire E Snader, Thomas H. Marwick +4 more
In this clinically low risk group, estimated functional capacity was a strong and overwhelmingly important independent predictor of all-cause mortality among patients undergoing exercise Tl-201 SPECT testing.
Journal of the American Medical Informatics AssociationUse of Commercial Record Linkage Software and Vital Statistics to Identify Patient Deaths
200 Citations1997Thomas B. Newman, Andrew Brown
International Journal of Health ServicesSocial Class: The Missing Link in U.S. Health Data
166 Citations1994Nancy Krieger, Elizabeth Fee
The authors argue that educational level is an insufficient marker for socioeconomic position and contend that appropriate measures must take into account not only individual but also household and neighborhood markers of social class in the U.S. context.
JAMASocioeconomic Status, Service Patterns, and Perceptions of Care Among Survivors of Acute Myocardial Infarction in Canada
157 Citations2004David A. Alter
DiabetesAssociation of Fasting Plasma Glucose With Heart Rate Recovery in Healthy Adults
150 Citations2002Claudia Panzer, Michael S. Lauer +3 more
Fasting plasma glucose is strongly and independently associated with abnormal heart rate recovery, even at nondiabetic levels, and added to impaired fasting plasma glucose for the prediction of death.
Journal of Public Health PolicyTobacco and Alcohol Billboards in 50 Chicago Neighborhoods: Market Segmentation to Sell Dangerous Products to the Poor
146 Citations1995Diana Hackbarth, Barbara Silvestri +1 more
A study of billboard advertising of tobacco and alcohol products in the city of Chicago revealed that minority wards were burdened with three times as many tobacco billboards and five times as much alcohol billboards when compared to white wards.
Medicine & Science in Sports & ExercisePhysical activity in the prevention and treatment of hypertension in the obese
140 Citations1999Robert Fagard
Assessing the value of physical exercise in the prevention and treatment of hypertension with particular attention to possible interactions with relative weight found it to contribute to the control of blood pressure in overweight as well as in lean subjects.
CirculationLong-Term Survival After Acute Myocardial Infarction Is Lower in More Deprived Neighborhoods
125 Citations2005Cathryn Tonne, Joel Schwartz +4 more
Within a medium-sized urban area, there are important variations in survival after hospital discharge for AMI that are associated with socioeconomic position, and these associations persist after adjustment for demographic and clinical characteristics.
Baillière s Clinical Endocrinology and MetabolismStress-induced activation of the sympathetic nervous system
118 Citations1987David S. Goldstein
Although acute stress- induced SAMS activation can be a health hazard, the role of chronically repeated, stress-induced SAMSactivation in the development of cardiovascular disease remains unclear.
Journal of Cardiopulmonary RehabilitationImprovement in Heart Rate Recovery After Cardiac Rehabilitation
98 Citations2003Susan Tiukinhoy, Nirat Beohar +1 more
As a simple parameter for assessing autonomic tone, HRR may be used in a cardiac rehabilitation facility to identify patients with higher risk profiles, and can be useful for evaluating patient outcomes.
American Heart JournalHeart rate recovery after exercise is related to the insulin resistance syndrome and heart rate variability in elderly men
93 Citations2002Lars Lind, Bertil Andrén
Heart rate recovery 1 minute after exercise was related to measurements of 24-hour heart rate variability, thereby establishing a link between this syndrome and cardiac autonomic nervous activity.
American Heart JournalDepression but not anxiety influences the autonomic control of heart rate after myocardial infarction
88 Citations2001Maria Vittoria Pitzalis, Massimo Iacoviello +7 more
In patients with myocardial infarction, depression but not anxiety negatively influences autonomic control of heart rate, and beta-blockers modify these influences.
Diabetes CareAssociation of Triglyceride–to–HDL Cholesterol Ratio With Heart Rate Recovery
82 Citations2004Mehdi H. Shishehbor, Byron J. Hoogwerf +1 more
HRR is associated with triglyceride-to-HDL cholesterol ratio and identifies patients with insulin resistance who are at increased risk of death.
The American Journal of MedicineAssociation of smoking with abnormal exercise heart rate responses and long-term prognosis in a healthy, population-based cohort
30 Citations2000Ravi Srivastava, Eugene H. Blackstone +1 more
In this large, middle-aged population-based cohort, smoking was associated with chronotropic incompetence, which in turn identified smokers with a particularly high mortality rate.
CirculationPersistent Social Patterning of Cardiovascular Risk
27 Citations2005Ana V. Diez Roux
The strength and persistence of these patterns suggest a pervasive influence of social context on the body and on the cardiovascular system in particular, which is striking given the crudeness with which social factors are usually measured in epidemiological and clinical studies.
The American Journal of MedicineAssociation of educational status with heart rate recovery: a population-based propensity analysis
14 Citations2002Mehdi H. Shishehbor, David W. Baker +2 more
Journal of Cardiopulmonary RehabilitationIs Heart Rate Recovery a Modifiable Risk Factor?
13 Citations2003Michael S. Lauer
The Journal of Rural HealthImproving Access to Capital for Health Care Infrastructure: The Experience of the Southern Rural Access Program's Revolving Loan Fund
10 Citations2003M. Kathryn Stewart, Michael Beachler +1 more
This paper describes the 5 operational loan funds in Arkansas, Louisiana, Mississippi, South Carolina, and West Virginia receiving support from the Southern Rural Access Program and outlines major distinctive features of these 2 approaches and describes major implementation challenges these loan funds face.
The Journal of Rural HealthLessons Learned in Phase I of the Southern Rural Access Program
5 Citations2003Michael Beachler, Curtis Holloman +1 more
The Robert Wood Johnson Foundation's Southern Rural Access Program has been an important investment of philanthropic funds to augment resources and improve health care access in underserved rural communities and suggests that a concentrated regional approach has merit.
