Abstract
Introduction: Socioeconomic position (SEP) is one of the main determinants of cardiovascular health (CVH). Among Hispanic/Latino populations living in the US, economic hardship is a leading stressor and a risk factor for suboptimal CVH. However, little is known about how changes in SEP can influence CVH across generations.
Hypothesis: We hypothesized worse CVH for offspring and caregivers with persistent low SEP versus higher intergenerational SEP.
Methods: The Hispanic Community Children's Health Study/Study of Latino Youth (SOL Youth; 2012-2014) is a cross-sectional study of 1466 Hispanic/Latino youth (aged 8-16 years). Social mobility was assessed using the grandparents' and caregivers' SEP. Grandparents' SEP was defined using the highest level of education attained by grandmother or grandfather: lower (<High school) or higher (≥High school). Caregivers' SEP was defined according to their education and income: lower (education <High school and income <30k) or higher (education ≥High school or income ≥30k). Social mobility was classified as stable low, downward, upward, and stable high groups. CVH was assessed for caregivers and offspring based on Life's Essential 8 (LE-8). We conducted survey linear regression models to investigate the association between social mobility and caregivers' (n=848) and offspring's (n=1217) CVH, adjusting for age, sex, place of birth, Hispanic/Latino background, and field center.
Results: Among caregivers, lower total LE-8 scores were observed for stable low [β= -3.91(-7.33; -0.49)] and downward [β= -4.85 (-9.61; -0.09)] groups compared to those in the stable high group. Lower BMI scores were observed in the stable low [β= -7.87 (-15.31; -0.43)] compared to those in the stable high group. Lower diet [β= -8.57(-16.75; -0.38)] and nicotine exposure [β= -22.23 (-34.48; -9.98)] scores were observed in the downward group compared to the stable high group. Among offspring, lower total LE-8 [β= -3.00 (-5.24; -0.75)] and glucose [β= -4.96 (-7.89; -2.04) scores were observed in the stable low compared to the stable high group.
Conclusions: Among Hispanic/Latinos, the intergenerational persistence of low SEP was associated with worse CVH in caregivers and their offspring compared to remaining in high SEP. Our findings highlight that disadvantages transferred across generations may help explain how CVH disparities emerge early in life. Future policies focused on structural interventions are needed to address these disparities in CVH.