A Structural Equation Modeling Approach for the Impact of Socioeconomic Status on Blood Pressure among Older Adults in India and the Role of Mediators - Evidence from the Longitudinal Aging Study of India - Wave 1.
IF 0.7 4区 医学Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
{"title":"A Structural Equation Modeling Approach for the Impact of Socioeconomic Status on Blood Pressure among Older Adults in India and the Role of Mediators - Evidence from the Longitudinal Aging Study of India - Wave 1.","authors":"G J Miller","doi":"10.4103/ijph.ijph_763_24","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Raised blood pressure (BP) is an important risk factor for cardiovascular diseases. Research has shown a negative gradient of BP with socioeconomic status (SES) in developed countries. However, studies in India reveal conflicting results.</p><p><strong>Objectives: </strong>To examine the association between SES and BP among older adults in India and to explore the mediating mechanisms.</p><p><strong>Methods: </strong>Structural Equation Modeling was employed to investigate the association of SES indicators (monthly per-capita expenditure and education) with systolic and diastolic BP using the cross-sectional data from Longitudinal Aging Study of India- Wave-1 (2017-2019). Separate models were fitted for rural men, rural women, urban men, and urban women to capture the residence- and gender-based variations. Mediating effects of bio-behavioral risk factors and antihypertensive medication use were explored.</p><p><strong>Results: </strong>The sample size under analysis was 59,333. After adjusting for age, SES was positively associated with systolic and diastolic BP in both rural men and women. A clear pattern was not observed in urban men, while a negative association was observed in urban women. The hypothesized mediators exhibited a harmful mediating effect in all associations, with Body Mass Index being the strongest. There existed a significant protective effect of raising SES on BP in urban women which was not explained by the mediators.</p><p><strong>Conclusion: </strong>In a country like India undergoing rapid socioeconomic changes, BP complexly interacts with SES, varying between residence and genders. This underscores the need for further exploration to inform effective public health interventions.</p>","PeriodicalId":13298,"journal":{"name":"Indian journal of public health","volume":" ","pages":""},"PeriodicalIF":0.7000,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian journal of public health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4103/ijph.ijph_763_24","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Raised blood pressure (BP) is an important risk factor for cardiovascular diseases. Research has shown a negative gradient of BP with socioeconomic status (SES) in developed countries. However, studies in India reveal conflicting results.
Objectives: To examine the association between SES and BP among older adults in India and to explore the mediating mechanisms.
Methods: Structural Equation Modeling was employed to investigate the association of SES indicators (monthly per-capita expenditure and education) with systolic and diastolic BP using the cross-sectional data from Longitudinal Aging Study of India- Wave-1 (2017-2019). Separate models were fitted for rural men, rural women, urban men, and urban women to capture the residence- and gender-based variations. Mediating effects of bio-behavioral risk factors and antihypertensive medication use were explored.
Results: The sample size under analysis was 59,333. After adjusting for age, SES was positively associated with systolic and diastolic BP in both rural men and women. A clear pattern was not observed in urban men, while a negative association was observed in urban women. The hypothesized mediators exhibited a harmful mediating effect in all associations, with Body Mass Index being the strongest. There existed a significant protective effect of raising SES on BP in urban women which was not explained by the mediators.
Conclusion: In a country like India undergoing rapid socioeconomic changes, BP complexly interacts with SES, varying between residence and genders. This underscores the need for further exploration to inform effective public health interventions.
期刊介绍：
Indian Journal of Public Health is a peer-reviewed international journal published Quarterly by the Indian Public Health Association. It is indexed / abstracted by the major international indexing systems like Index Medicus/MEDLINE, SCOPUS, PUBMED, etc. The journal allows free access (Open Access) to its contents and permits authors to self-archive final accepted version of the articles. The Indian Journal of Public Health publishes articles of authors from India and abroad with special emphasis on original research findings that are relevant for developing country perspectives including India. The journal considers publication of articles as original article, review article, special article, brief research article, CME / Education forum, commentary, letters to editor, case series reports, etc. The journal covers population based studies, impact assessment, monitoring and evaluation, systematic review, meta-analysis, clinic-social studies etc., related to any domain and discipline of public health, specially relevant to national priorities, including ethical and social issues. Articles aligned with national health issues and policy implications are prefered.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
