American Journal of Epidemiology Advance Access originally published online on May 8, 2009
American Journal of Epidemiology 2009 169(12):1411-1421; doi:10.1093/aje/kwp082
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Occupation as Socioeconomic Status or Environmental Exposure? A Survey of Practice Among Population-based Cardiovascular Studies in the United States
Correspondence to Dr. Leslie MacDonald, Industrywide Studies Branch, Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, 4676 Columbia Parkway, Mailstop R-15, Cincinnati, OH 45226-1998 (e-mail: lmacdonald{at}cdc.gov).
Received for publication September 24, 2008. Accepted for publication January 9, 2009.
Decisions about how occupation is used in epidemiologic research can affect conclusions about the importance of socioeconomic and environmental factors in explaining disparities for outcomes such as cardiovascular disease. A review of practices in the collection and use of occupational data was conducted among population-based cardiovascular studies in the United States. Studies were identified for review from the National Heart, Lung, and Blood Institute website and the biomedical database, Computer Retrieval of Information on Scientific Projects, by use of selected criteria. Data collection instruments and study publications were retrieved and reviewed for 30 of 33 studies (91%). Most of the studies (83%) collected at least descriptive occupational data, and more than half (60%) collected data on workplace hazards. The reviewed studies produced 80 publications in which occupational data were used in analyses, most often as an indicator of socioeconomic status. Authors rarely acknowledged known conceptual and empirical links among socioeconomic status, employment stability, and working conditions. Underutilization of data on workplace conditions was found. Existing data could be used more effectively to examine the contribution of work-related social and environmental conditions to the development of modifiable cardiovascular disease through multiple pathways.
cardiovascular diseases; environment and public health; epidemiologic research design; occupations; social class
Abbreviations: CVD, cardiovascular disease; SES, socioeconomic status
Editor's note: An invited commentary on this article appears on page 1422, and the authors’ response is published on page 1426.
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Related articles in Am. J. Epidemiol.:
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Am. J. Epidemiol. 2009 169: 1422-1425.[Abstract] [Full Text] - MacDonald et al. Respond to "Search for Preventable Causes of Cardiovascular Disease"
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