TY - JOUR
T1 - Adolescent Psychological Assets and Cardiometabolic Health Maintenance in Adulthood
T2 - Implications for Health Equity
AU - Qureshi, Farah
AU - Guimond, Anne Josee
AU - Tsao, Elaine
AU - Delaney, Scott
AU - Boehm, Julia K.
AU - Kubzansky, Laura D.
N1 - Funding Information:
This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill and funded by grant T32HL098048 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health (NIH), with cooperative funding from 23 other federal agencies and foundations. Information on how to obtain the Add Health data files is available on the Add Health website (https://addhealth.cpc.unc.edu). For this work, F. Qureshi was supported by NIH grant T32 CA 009001. A.-J. Guimond was supported by the Canadian Institute of Health Research. S. Delaney was supported by NIH grant T32 MH 017119. A.-J. Guimond, E. Tsao, S. Delaney, and L. Kubzansky received support from the Lee Kum Sheung Center for Health and Happiness at the Harvard T.H. Chan School of Public Health. The content of this manuscript is the sole responsibility of the authors.
Publisher Copyright:
© 2023 The Authors.
PY - 2023/1/17
Y1 - 2023/1/17
N2 - BACKGROUND: Positive cardiometabolic health (CMH) is defined as meeting recommended levels of multiple cardiometabolic risk factors in the absence of manifest disease. Prior work finds that few individuals—particularly members of minoritized racial and ethnic groups—meet these criteria. This study investigated whether psychological assets help adolescents sustain CMH in adulthood and explored interactions by race and ethnicity. METHODS AND RESULTS: Participants were 3478 individuals in the National Longitudinal Study of Adolescent Health (49% female; 67% White, 15% Black, 11% Latinx, 6% other [Native American, Asian, or not specified]). In Wave 1 (1994–1995; mean age=16 years), data on 5 psychological assets (optimism, happiness, self-esteem, belongingness, and feeling loved) were used to create a composite asset index (range=0– 5). In Waves 4 (2008; mean age=28 years) and 5 (2016– 2018; mean age=38 years), CMH was defined using 7 clinically assessed biomarkers. Participants with healthy levels of ≥6 biomarkers at Waves 4 and 5 were classified as maintaining CMH over time. The prevalence of CMH maintenance was 12%. Having more psychological assets was associated with better health in adulthood (odds ratio [OR]linear trend, 1.12 [95% CI, 1.01–1.25]). Subgroup analyses found substantive associations only among Black participants (OR, 1.35 [95% CI, 1.00–1.82]). Additionally, there was some evidence that racial and ethnic disparities in CMH maintenance may be less pronounced among participants with more assets. CONCLUSIONS: Youth with more psychological assets were more likely to experience favorable CMH patterns 2 decades later. The strongest associations were observed among Black individuals. Fostering psychological assets in adolescence may help prevent cardiovascular disease and play an underappreciated role in shaping health inequities.
AB - BACKGROUND: Positive cardiometabolic health (CMH) is defined as meeting recommended levels of multiple cardiometabolic risk factors in the absence of manifest disease. Prior work finds that few individuals—particularly members of minoritized racial and ethnic groups—meet these criteria. This study investigated whether psychological assets help adolescents sustain CMH in adulthood and explored interactions by race and ethnicity. METHODS AND RESULTS: Participants were 3478 individuals in the National Longitudinal Study of Adolescent Health (49% female; 67% White, 15% Black, 11% Latinx, 6% other [Native American, Asian, or not specified]). In Wave 1 (1994–1995; mean age=16 years), data on 5 psychological assets (optimism, happiness, self-esteem, belongingness, and feeling loved) were used to create a composite asset index (range=0– 5). In Waves 4 (2008; mean age=28 years) and 5 (2016– 2018; mean age=38 years), CMH was defined using 7 clinically assessed biomarkers. Participants with healthy levels of ≥6 biomarkers at Waves 4 and 5 were classified as maintaining CMH over time. The prevalence of CMH maintenance was 12%. Having more psychological assets was associated with better health in adulthood (odds ratio [OR]linear trend, 1.12 [95% CI, 1.01–1.25]). Subgroup analyses found substantive associations only among Black participants (OR, 1.35 [95% CI, 1.00–1.82]). Additionally, there was some evidence that racial and ethnic disparities in CMH maintenance may be less pronounced among participants with more assets. CONCLUSIONS: Youth with more psychological assets were more likely to experience favorable CMH patterns 2 decades later. The strongest associations were observed among Black individuals. Fostering psychological assets in adolescence may help prevent cardiovascular disease and play an underappreciated role in shaping health inequities.
KW - cardiometabolic health
KW - health assets
KW - health equity
KW - life course
KW - psychological well-being
KW - social epidemiology
UR - http://www.scopus.com/inward/record.url?scp=85146365344&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85146365344&partnerID=8YFLogxK
U2 - 10.1161/JAHA.122.026173
DO - 10.1161/JAHA.122.026173
M3 - Article
C2 - 36628968
AN - SCOPUS:85146365344
SN - 2047-9980
VL - 12
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 2
M1 - e026173
ER -