Relationships of Education and Occupation to Coronary Heart Disease Risk Factors in Schoolchildren and Adults: The Princeton School District Study

Khoury, P. R., J. A. Morrison, P. Laskarzewski, K. Kelly, M. J. Mellies, P. King, R. Larsen, and C. J. Glueck (U. of Cincinnati, College of Medicine, Cincinnati, OH 45267). Relationships of education and occupation to coronary heart disease risk factors in schoolchildren and adults: the Princeton School District Study. Am J Epidemiol 1981; 113: 378–95. The specific aims of this study in the biracial socioeconomically varied Princeton School District (suburban Cincinnati, Ohio) were to describe associations between socioeconomic status (SES), as indicated by education and occupation of the head of the household (EDHD, OCCHD), and coronary heart disease (CHD) risk factors in children and adults, and to determine to what degree, if any, black-white CHD risk factor differences were accounted for by differing black-white SES. The study included 893 schoolchildren, ages 6–19 years, and 362 adults randomly recalled in the Cincinnati Lipid Research Clinic's Princeton School District Study. Generally, the patterns of relationships between parental EDHD andor OCCHD and risk factors were similar for girls and boys, but were more variegated for women and men. In children there were positive simple correlations between parental SES and nutrient intake, and inverse associations with smoking, Quetelet Index, age, and race. In adults, intake of carbohydrates other than sucrose or starch was positively related to the SES of the head of household; smoking, Quetelet index and race were inversely related, as were plasma triglycerlde (in women) and systolic blood pressure (in men). After adjustment for race and age, the relationships of SES to risk factors in children and adults remained generally unchanged, with the exception of Quetelet index and systolic blood pressure which no longer retained their significant inverse relationships with SES. Most major black-white differences in CHD risk factor levels were significant after adjustment for racial disparity in EDHD and OCCHD, suggesting that the appreciable black-white SES differences in the Princeton School District did not account for black-white differences in CHD risk factors. Thus, black men, boys, and girls had higher adjusted mean high density lipoprotein cholesterol than whites; whites had higher triglyceride levels than blacks. Black adults had higher systolic and diastolic blood pressure than whites; black women had a higher Quetelet index than white women. Higher SES might speculatively be associated with reduced aggregate CHD risk, by virtue of its negative correlation with cigarette smoking, blood pressure, and varied nutrient intakes.