American Journal of Epidemiology Vol. 148, No. 6: 581-593
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health
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Socioeconomic Status Differences in Hormone Therapy
1Child and Family Studies, School of Human Ecology, University of Wisconsin-Madison Madison, WI
2Department of Sociology, College of Letters and Sciences, University of Wisconsin-Madison Madison, WI
Reprint requests to Dr. Nadine Marks, Child and Family Studies, School of Human Ecology, University of Wisconsin-Madison, 1430 Linden Drive, Madison, WI 53706.
Socioeconomic status (SES) is a significant sociodemographic correlate of noncontraceptive hormone therapy, yet multiple dimensions of SES have not been examined systematically in previous studies of hormone therapy. This study examined the lifetime incidence of noncontraceptive hormone therapy, how usage varied by type of reproductive organ surgery, and the bivariate and net associations between a large array of SES indicators and the likelihood of ever using hormones by age 53–54 years in a population sample (n = 3,612) of non-Hispanic white female participants in the Wisconsin Longitudinal Study (1957–1993). Approximately half of the women had ever used noncontraceptive hormones; 38.5% were current users. In multivariate logistic regression analyses, the most robust SES predictor of hormone therapy was a woman's husband's occupational status (higher status associated with higher rates of use), after adjustment for all other measured sociologic and biomedical factors (e.g., other SES measures, other health behaviors, menopausal symptoms, age at menopause, health insurance). The association of hormone therapy with education differed between women who underwent hysterectomy and/or oophorectomy (higher odds for less educated women) and those with intact reproductive organs (lower odds for less educated women). Additionally, a woman's own earnings and household net worth were positive net correlates of noncontraceptive hormone therapy. Am J Epidemiol 1998;148:581–93.
estrogen replacement therapy; hormones; menopause; social class; women
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