SOCIAL STATUS AND INCIDENCE OF CORONARY HEART DISEASE

This study tested the hypothesis that 5 types of incongruity in social status are associated with increased risk of coronary heart disease (CHD). It also investigated prospectively the relationship between 7 variables of social status and incidence of CHD. The cohort comprised 1472 married, middle-aged Caucasian men employed by an industry in metropolitan Chicago. All subjects were free of clinical CHD when social status was measured. Cases of CHD occurring in the subsequent 5 yr were detected by annual examinations. Results of this study support the hypothesis that incongruities in social status are associated with increased risk of CHD. Incidence of CHD increased as the number of incongruities per subject increased, and men with 4 or 5 incongruities were found to have about 6 times the risk of CHD as compared to men with none of the incongruities studied here. This association could not be explained by correlation between number of incongruities per subject and serum cholesterol, arterial pressure, blood glucose, age, educational status, relative weight, and cigarette smoking. This study also found that incidence of CHD in this cohort was associated with educational status, but that the form of the relationship varied according to the clinical form by which the disease was first manifested. Caution should be observed in generalizing these results beyond the specific social organization in which they were observed. © 1969.