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The gene-centric Human CVD BeadChip (Illumina) approach is employed to determine and identify different association signals that are shown to be linked with lipids and apoliproteins. The individual differences observed in the potential of blood lipids to assess CVD risk are shown to be highly related to the multiple common alleles.

Social inequalities are a proper concern of epidemiology. Epidemiological thinking and modes of analysis are central, but epidemiological research is one among many areas of study that provide the evidence for understanding the causes of social inequalities in health and what can be done to reduce them. Understanding the causes of health inequalities requires insights from social, behavioral and biological sciences, and a chain of reasoning that examines how the accumulation of positive and negative influences over the life course leads to health inequalities in adult life. Evidence that the social gradient in health can be reduced should make us optimistic that reducing health inequalities is a realistic goal for all societies. [ABSTRACT FROM AUTHOR]

Summary: Objectives: To assess whether C-reactive protein (CRP) and interleukin-6 (IL-6) are associated with low cognitive performance and decline in middle-aged adults. Design/setting: The Whitehall II study; an ongoing large-scale, prospective occupational cohort study of employees from 20 London-based white-collar Civil Service departments. Participants: Data from more than 3000 males and 1200 female employees. Measures: Inflammatory makers measured in 1991–1993 and five cognitive tests (short-term verbal memory, inductive reasoning (AH4-I), vocabulary (Mill Hill), and phonemic and semantic fluency) performed in 1997–1999 and 2002–2004. Performance in the lowest sex-specific quintile indicated low cognitive performance or decline. Covariates included sociodemographics, health behaviours and health conditions. Results: In age-adjusted analyses both CRP and IL-6 were associated with all cognitive measures in 1997–1999, even though the association with memory was not consistent. After extensive adjustment raised CRP levels were only associated with poor cognitive performance on the AH4-I (OR=1.38; 95% CI: 1.05–1.82) and Mill Hill (OR=1.52; 95% CI: 1.14–2.03) and IL-6 on semantic fluency (OR=1.27; 95% CI: 1.14–2.03). Associations were more evident in men than in women. No clear relationship was observed for decline. Conclusions: Our results suggest that raised levels of inflammatory markers in midlife are moderately associated with lower cognitive status, but little with cognitive decline. [Copyright &y& Elsevier]

Background: Few studies have examined the long-term effect of habitual diet on risks of incident diabetes, coronary heart disease, and mortality. Objective: We analyzed the prospective relation of dietary patterns with incident chronic disease and mortality during 15 y of follow-up in the Whitehall II study. Design:Weconducted a prospective analysis (106 633 person-years at risk) among men and women (n = 7731) with a mean age of 50 y at the time of dietary assessment (127-item food-frequency questionnaire). Coronary death or nonfatal myocardial infarction and incident diabetes were verified by record tracing and oral-glucosetolerance tests. Results: Cluster analysis identified 4 dietary patterns at baseline. The patterns were termed unhealthy (white bread, processed meat, fries, and full-cream milk; n = 2665), sweet (white bread, biscuits, cakes, processed meat, and high-fat dairy products; n = 1042), Mediterranean-like (fruit, vegetables, rice, pasta, and wine; n = 1361), and healthy (fruit, vegetables, whole-meal bread, low-fat dairy, and little alcohol; n = 2663). Compared with the unhealthy pattern, the healthy pattern reduced the risk of coronary death or nonfatal myocardial infarction and diabetes; hazard ratios (95% CI) were 0.71 (0.51, 0.98) and 0.74 (0.58, 0.94), respectively, after adjustment for age, sex, ethnicity, dietary energy misreporting, social position, smoking status, and leisure-time physical activity. Dietary pattern was not associated with all-cause mortality. Residual confounding by socioeconomic factors was unlikely to account for the observed dietary effects. Conclusions: The healthy eating pattern reduced risks of diabetes and major coronary events. Such dietary patterns offer considerable health benefits to individuals and contribute to public health. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To extend the model of effort–reward imbalance at work to close and more general social relationships and test the associations with different measures of health. Lack of reciprocity at work is associated with poorer health in a number of studies. However, few studies have analysed the effect of nonreciprocity in other kinds of social relationships on health. Methods: The Whitehall II Study is an ongoing prospective study of British civil servants (n=10308 at baseline in 1985–88). Cross-sectional data from the latest phase (7, n=6944 in 2002–04) were used in the analyses. The main exposure was a questionnaire measuring nonreciprocal social relations in partnership, parent–children, and general trusting relationships. Health measures included the SF-36 mental and physical component scores, General Health Questionnaire-30 depression subscale, Jenkins'' Sleep disturbance questionnaire, and the Rose Angina questionnaire. Logistic and linear regression models were analysed, adjusted for potential confounders, and mediators of the association. Results: Lack of reciprocity is associated with all measures of poorer health. This association attenuates after adjustment for previous health and additional confounders and mediators but remains significant in a majority of models. Negative social support from a close person is independently associated with reduced health, but adjusting for this effect does not eliminate the association of nonreciprocity with poor health. Conclusion: The effort–reward imbalance at work model has been extended to close and more general social relationships. Lack of reciprocity in partnership, parent–children and general trusting relationships is associated with poorer health. [Copyright &y& Elsevier]

Background and Objectives: Research shows elevated levels of blood pressure in midlife to be linked to impaired cognitive performance in old age. However, it remains unclear if this association extends to younger age groups. The objective of this study was to examine the association between hypertension and a range of cognitive abilities in middle aged men and women.Methods: Data are from the Whitehall II study. Measures of blood pressure were obtained at baseline (1985-1988) and two subsequent phases of data collection (1991-1994 and 1997-1999). Cognitive function (memory test, AH 4-I, Mill-Hill, phonemic and semantic fluency) was assessed (1997-1999) when participants (N = 5,838) were aged 46-68 years old.Results: Results show a small inverse association between both diastolic and systolic blood pressure and cognitive performance, independent of age, education, employment grade, smoking status, alcohol consumption, use of antihypertensive medication, diagnoses of diabetes, and cardiovascular disease. Similar associations were seen with prospective and cross-sectional analyses. The effect of hypertension was stronger in women, and stronger for cognitive measures assessing executive function.Conclusion: Expanding on previous studies on older participants, the present study reports a small, but significant association between hypertension and poor cognitive performance in middle-aged men and women. [ABSTRACT FROM AUTHOR]

This paper argues that social selection, materialist/structural and cultural/behavioural explanations for social inequalities in health are related to each other through the mechanism of socialization, seen here as a process through which societies shape patterns of behaviour and being that then affect health. Socialization involves the inter- and intragenerational transfer of attitudes, beliefs and behaviours. Parallels between socialization theory and Bourdieu's concept of habitus are also drawn, and the implications for social epidemiology are discussed. Four key areas that would benefit from research within the socialization framework are identified: health behaviours, psychological vulnerability, social skills and future time perspective. [ABSTRACT FROM AUTHOR]

Purpose: To examine the social, biological, and metabolic associations of plasma viscosity in a large epidemiological study. Methods: Plasma viscosity was measured from 4548 men and 1837 women that took part in the fifth phase of the Whitehall II Study (1997–1999). Employment grade was used as a measure of social position. Results: A strong inverse relation between employment grade and plasma viscosity was evident (p < 0.0001). This employment grade gradient was apparent overall, and among non-smokers and when participants with poor health were removed from the analyses. Plasma viscosity was associated with a number of biological factors that are themselves socially determined, including fibrinogen (p < 0.001), triglycerides (p < 0.001), fasting insulin (p < 0.001), and height (p < 0.001). Associations with smoking and alcohol intake were apparent in women. In men a U-shaped curve was apparent such that those drinking between 11 and 24 units/week had the lowest plasma viscosity. Alcohol intake, physical activity, and smoking explained 18% of the grade gradient in men and 40% in women while the biological factors examined accounted for 35% in men and 40% in women. Conclusion: There is a grade gradient in plasma viscosity which was not fully explained by health related behaviors or measured risk factors for CHD. These data suggest that additional factors that contribute to the rheological properties of plasma may contribute to the explanation for social inequalities in cardiovascular disease. [Copyright &y& Elsevier]

As social inequalities in health continue to be a key public health problem, scientific advances in explaining these inequalities are needed. It is unlikely that there will be a single explanation of social inequalities in health. This introductory paper sets out one explanatory framework, exposure to adverse psychosocial environments during midlife, and particularly at work. We argue that exposure to an adverse psychosocial environment, in terms of job tasks, defined by high demands and low control and/or by effort–reward imbalance, elicits sustained stress reactions with negative long-term consequences for health. These exposures may be implicated in the association of socioeconomic status with health in two ways. First, these exposures are likely to be experienced more frequently among lower socioeconomic groups. Second, the size of the effects on health produced by adverse working conditions may be higher in lower status groups, due to their increased vulnerability.In this special issue, these arguments are illustrated by a collection of original contributions from collaborative research across Europe. The papers, in our view, advance the case for the robust associations between measures of adverse psychosocial environment and ill health, as they are based on comparative studies across several European countries and as they combine different types of study designs. This collaboration was enabled and supported by a European Science Foundation scientific programme on ‘Social Variations in Health Expectancy in Europe’. [Copyright &y& Elsevier]

Rates of myocardial infarction and stroke increase as countries “develop.” These disorders emerge among higher socio-economic groups, but once “developed,” most events occur in lower socio-economic groups. We evaluated the association between education as a measure of socio-economic status and risk of acute myocardial infarction (AMI) and stroke in regions at various stages of development and between stroke risk and life expectancy. The study comprised 2,478 cases of AMI or stroke and 6,819 controls among women aged 19–49, from Africa, Asia, Latin America, and Eastern Europe. Compared to those with high educational attainment, stroke risk was reduced among less educated women in Africa, but was significantly higher in the other three regions. Low education was associated with increased risk of AMI in Eastern Europe but not in the other three regions combined. Educationally related stroke risk was positively correlated with national life expectancy. [Copyright &y& Elsevier]

Focuses on socioeconomic differences in weight gain and determinants and consequences of coronary risk factors among civil servants in London, England. Body mass index; Obesity.

Presents results of studies designed to understand health inequalities in different populations in the United States and Great Britain. Inequalities in measures of morbidity and psychological well-being; Relation between different measures of socioeconomic position and health status.

In South Asians (Indians, Pakistanis, and Bangladeshis) settled overseas, high rates of coronary disease and non-insulin-dependent diabetes occur in association with central obesity and insulin resistance. To examine whether these disturbances were related to diet, we measured 7-d weighed intakes in 173 South Asian and European men aged 40-69 y in London. In South Asians compared with Europeans, respectively, mean energy intake was lower (9.5 vs 10.8 MJ/day, P < 0.001), total fat intake was lower (36.5% vs 39.2% of energy intake, P = 0.007), stanch intake was higher (28.0% vs 21.5% of energy, P < 0.001), polyunsaturated fatty acid intake was higher (8.2% vs 7.0% of energy, P = 0.02), and dietary fiber intake was higher (3.2 vs 2.0 g/MJ, P < 0.001). Elevated serum insulin concentrations at 2 h postglucosc were associated positively with carbohydrate intake (P = 0.001) and inversely with alcohol intake (P = 0.006), but not with saturated fatty acid intake. The high coronary risk in South Asian people is not explained by any unfavorable characteristic of South Asian diets. [ABSTRACT FROM AUTHOR]

Abstract: The authors examined the association of ‘g’ (general intelligence) factor and five specific cognitive measures assessed in 1997–1999 with mortality till 2006 (mean follow-up of 8 years) in the middle-aged Whitehall II cohort study. In age- and sex-adjusted analysis, a decrease in 1 S.D. in memory (hazard ratio (HR), 1.19; 95% confidence interval (CI): 1.02, 1.39) and in Alice Heim 4-I (AH4-I) (HR, 1.16; 95% CI: 1.01, 1.35) was found to be associated with higher mortality. The association with ‘g’ factor, phonemic and semantic fluency did not reach significance at p <0.05. No association was found with vocabulary. Out of education, health behaviours and health measures, it was health behaviours that explained the greater part of the association between cognition and mortality, ranging from 21% for memory to 70% for semantic fluency. All the covariates taken together explained only 26% of the association with memory and between 33 and 90% for the other cognitive measures. This study suggests that ‘g’ type composite measure of cognition might not be enough to understand the associations between cognition and health. [Copyright &y& Elsevier]

Abstract: Objective: To discover whether positive affect and purpose in life (eudaimonic well-being) are associated with good sleep independently of health problems and socioeconomic status, and to evaluate their role in mediating the influence of psychosocial risk factors on poor sleep. Methods: A cross-sectional study was carried out with 736 men and women aged 58–72 years, with positive affect assessed by aggregating ecological momentary samples. Sleep problems were assessed with the Jenkins Sleep Problems Scale, and psychosocial risk factors were measured by standardized questionnaires. Results: Both positive affect and eudaimonic well-being were inversely associated with sleep problems after adjustment for age, gender, household income, and self-rated health (P<.001). Negative psychosocial factors including financial strain, social isolation, low emotional support, negative social interactions, and psychological distress were also related to reported sleep problems. The strength of these associations was reduced by 20–73% when positive affect and eudaimonic well-being were taken into account, suggesting that effects were partly mediated by positive psychological states. Conclusions: These results suggest that both positive affect and eudaimonic well-being are directly associated with good sleep and may buffer the impact of psychosocial risk factors. The relationships are likely to be bidirectional, with disturbed sleep engendering lower positive affect and reduced psychological well-being, and positive psychological states promoting better sleep. [Copyright &y& Elsevier]

Objectives: Little work has investigated the relationship between unfairness and risk factors for heart disease. We examine the role of unfairness in predicting the metabolic syndrome and explaining the social gradient of the metabolic syndrome.Methods: The design is a prospective study with an average follow-up of 5.8 years. Participants were 4128 males and 1715 females of 20 civil service departments in London (Whitehall II study). Sociodemographics, unfairness, employment grade, behavioral risk factors, and other psychosocial factors were measured at baseline (Phase 3, 1991-1993). Waist circumference, triglycerides, high-density lipoprotein (HDL) cholesterol, fasting glucose, and hypertension were used to define metabolic syndrome at follow-up (Phase 5, 1997-2000), according to the National Cholesterol Education Program/Adult Treatment Panel III guidelines.Results: Unfairness is positively associated with waist circumference, hypertension, triglycerides, and fasting glucose and negatively associated with serum HDL cholesterol. High levels of unfairness are also associated with the metabolic syndrome [odds ratio (OR)=1.72, 95% CI=1.31-2.25], after adjustment for age and gender. After additional adjustment for employment grade, behavioral risk factors, and other psychosocial factors, the relationship between high unfairness and metabolic syndrome weakened but remained significant (OR=1.37, 95% CI=1.00-1.93). When adjusting for unfairness, the social gradient of metabolic syndrome was reduced by approximately 10%.Conclusion: Unfairness may be a risk factor for the metabolic syndrome and its components. Future research is needed to study the biological mechanisms linking unfairness and the metabolic syndrome. [ABSTRACT FROM AUTHOR]

Purpose: To examine the association between socioeconomic position (SEP) over the lifecourse and cognitive function in middle age. Two alternative models were assessed: the “direct effects model” where temporally distinct measures of SEP have only direct effects on adult cognition, and the “indirect effects” model where the effect of early life SEP are mediated through later life measures of SEP. Methods: Data are from the Whitehall II study (N=10,308 at baseline), a longitudinal cohort study of British civil servants, aged between 46 and 68 years at the time of cognitive testing. Structural equation models were used to compare the fit of direct and indirect effects models, and quantify the effects of different measures of SEP on cognition. Childhood SEP, education, and adult SEP were used to model SEP across the lifecourse. Cognitive function was assessed as a latent construct composed of the following: verbal memory, AH 4-I, Mill Hill, phonemic and semantic fluency. Results: The indirect effects model provided a better fit to the data. Childhood SEP had no direct effect on cognitive function but had a substantial “indirect effect,” mediated through education and adult SEP. 78.4% of the effect of education in men and 100% in women was indirect. Conclusions: Socioeconomic differences in adult cognition are a result of the socioeconomic trajectory of individuals throughout their lifecourse. Early measures of SEP influence cognition indirectly, through their influence on later measures of SEP. [Copyright &y& Elsevier]

Objective: To examine change in health functioning as women progress through the menopausal transition.Study Design and Setting: Prospective study of 2,489 women followed through four phases of the Whitehall II study. Health functioning was assessed with the eight subscales of the SF-36.Results: Compared with peri- and postmenopausal women who did not experience menopausal symptoms, women who reported vasomotor symptoms or menopausal depression experienced large and significant declines on most scales of the SF-36. Women who reported the greatest symptom severity experienced the largest declines in functioning. For example, decline in physical functioning for perimenopausal women experiencing severe vasomotor symptoms was 3.3 (standard error SE=1.1) greater than those who experienced no vasomotor symptoms. Decline in role limitation-emotional for perimenopausal women experiencing severe menopause-associated depression was 18.4 (SE=2.3), compared with those who did not experience these symptoms. Vasomotor symptom reporting was predicted by low socioeconomic position, high body mass index, and limiting long-term illness at baseline. Menopause-associated depression was additionally predicted by smoking and depression.Conclusion: The menopausal transition is associated with decreased health functioning in women who report menopausal symptoms. Menopausal symptoms are strongly related to all aspects of health functioning assessed by the SF-36. Socioeconomic and behavioral risk factors for menopausal symptoms and associated declines in health functioning have been identified. [ABSTRACT FROM AUTHOR]

We compared the pattern of socioeconomic inequalities in physical functioning and perceived health among male and female employees in Britain, Finland and Japan. Participants were male and female public sector employees in Britain, Finland and Japan, who were economically active and 40–60 year-olds at the time of data collection. We measured perceived health and physical functioning (SF-36 physical component summary) with standardized health questionnaires. The results obtained here reconfirm the similarity of the patterns of ill-health of those with lower socioeconomic status among non-manual men and women in Britain and Finland. These data also provide good evidence for a socioeconomic gradient in ill-health among Japanese non-manual men, although this gradient was less systematic. For Japanese men poorer health of manual workers as compared to non-manual workers was well demonstrated. However, among Japanese women socioeconomic differences in health were small and inconsistent. In conclusion, Britain, Finland and Japan—representing ‘liberal’, ‘Nordic’ and ‘conservative’ welfare state regimes—produce broadly similar patterns of socioeconomic differences in health among men. However, different patterns of labour force participation and welfare provision in different welfare regimes may bring about different patterns of socioeconomic differences in health for working women. This is exemplified by the lack of health inequalities among employed Japanese women. [Copyright &y& Elsevier]

Objective: Results of investigations into the impact of seasonal variation on the incidence of cardiovascular diseases (CVD) have been inconsistent. Using the WHO Collaborative Study of CVD and Steroid Hormone Contraception database, we attempted to examine the relationship between variation in three climatic variables and risk of hospitalization for venous thromboembolism (VTE), arterial stroke, and acute myocardial infarction (AMI).Study design and setting: We compared the monthly mean temperature, rainfall, and humidity with rates of hospitalized VTE, stroke, and AMI among young women aged 15–49 from 17 different countries in Africa, Asia, Europe, Latin America, and the Caribbean by using a negative binomial regression model.Results: The study included 1146, 2,269, and 369 cases of VTE, stroke, and AMI, respectively. Significant associations between temperature and hospital admission rates of stroke and AMI, but not VTE, were apparent. Lagging the effects of temperature suggested that these effects were relatively acute, within a period of a month.Conclusion: These data may help in understanding the mechanisms whereby stroke and AMI events are triggered. [Copyright &y& Elsevier]

It is thought that the salivary cortisol awakening response can serve as a reliable marker of hypothalamic–pituitary–adrenocortical activity. Response magnitude might be influenced by stress, but results of studies on work-related stress have been inconclusive. Non-compliance with the sampling schedule is a potential confounding factor that has rarely been controlled. The objective of the study was to determine whether the cortisol awakening response is greater on a work day than on a weekend day, and whether responses vary with gender and socioeconomic position. Compliance was controlled by excluding participants who reported a delay of more than 10 min between waking up and taking the first saliva sample. Data were collected from 196 men and women aged 47 to 59 years drawn from the Whitehall II cohort of British civil servants, with free salivary cortisol sampled immediately after waking up and 30 min later on 2 days. Data on stress, perceived control and happiness over the remainder of the day, and on sleep quality, time of waking, and health behaviour were also obtained. The awakening response was lower in non-compliant participants than in compliant ones, so non-compliant participants were excluded from further analyses. Salivary cortisol levels on waking did not differ by gender or socioeconomic position, or between work and weekend days. However, the cortisol awakening response (defined as the difference between waking and 30 min later) was greater on work than weekend days (mean increases 10.5 and 3.7 nmol/l, P<0.001). On the work day, women showed larger increases than men (P=0.011), but there were no gender differences on the weekend day. Across both days, lower socioeconomic position was associated with a larger cortisol awakening response (P=0.014). Time of waking up was not related to the cortisol awakening response on either day. Participants rated themselves as more stressed, less in control, and less happy over the remainder of the work than weekend day. These results indicate that the cortisol awakening response occurs on both work and non-work days, but that anticipation of the working day is associated with an enhanced response. Cortisol output over the early part of the day may be particularly sensitive to the influence of chronic stress and its anticipation, especially in women. [Copyright &y& Elsevier]

: PurposeTo examine whether risk factors for CHD are related to change in functioning independent of the presence or development of disease.: MethodsLongitudinal follow up of 4768 men and 2034 women civil servants from 20 London-based departments with complete data for the SF-36, biological variables, and BMI and health related behaviors. Data are used from two phases of the Whitehall II study, phase 3 (1991–1993) and phase 4 (1995) with an interval of 36 months. Weight, height, fasting insulin, 2-hour post load glucose, total and HDL-cholesterol, fibrinogen, von Willebrand factor, diastolic and systolic blood pressure, and waist hip ratio were measured at phase 3. Demographic and socio-economic information, health related behaviors, and the SF-36 were obtained at both phases by questionnaire.: ResultsWaist hip ratio, fasting insulin, triglycerides, and HDL-cholesterol were associated with a decline in physical functioning in the total cohort and when those with poor health at baseline were removed from the analyses. Principal component analysis revealed that these variables clustered with total cholesterol and may represent insulin resistance. The biological variables had a cumulative effect on decline in physical functioning such that those with poor waist hip ratio, fasting insulin, triglycerides, and HDL-cholesterol was two times greater than those without. This relationship was independent of exercise, smoking, and alcohol intake which explained only 17% and 5.4% of the association in men and women, respectively.: ConclusionsA number of biological variables, which may represent insulin resistance, are associated with decline in physical functioning in men and women independent of prevalent ill health or health related behaviors. [Copyright &y& Elsevier]

The aim of the study is to (i) identify common dietary patterns, (ii) study socioeconomic differences in these dietary patterns, and (iii) assess whether they contribute to socioeconomic differences in biological risk factors. The data come from the Whitehall II study of London civil servants, who participated in the third phase (1991–1993) and were 39–63-years old (N=8004). Food frequency questionnaire and socioeconomic background information was from a questionnaire, and biological risk factors from a medical screening. Six dietary patterns were identified. In reference to high employment grade men, the odds ratios of low grade men consuming the ‘unhealthy’ or the ‘very unhealthy’ diet were 1.26 and 3.34, respectively, while the odds for the ‘French’ diet was 0.13. Among women the corresponding odds were 2.98, 6.19 and 0.25. Adjusting for spouse''s socioeconomic status and to a lesser extent smoking and exercise as well as job control attenuate these grade differences somewhat. Among men and women adjusting for dietary patterns accounted for about 25—50 per cent of grade differences in HDL and serum triglyceride levels. [Copyright &y& Elsevier]

The purpose of this study was twofold—(1) investigate the role of subjective social status as a predictor of ill-health, with a further exploration of the extent to which this relationship could be accounted for by conventional measures of socioeconomic position; (2) examine the determinants of a relatively new measure of subjective social status used in this study. A 10 rung self-anchoring scale was used to measure subjective social status in the Whitehall II study, a prospective cohort study of London-based civil service employees. Results indicate that subjective status is a strong predictor of ill-health, and that education, occupation and income do not explain this relationship fully for all the health measures examined. The results provide further support for the multidimensional nature of both social inequality and health. Multiple regression shows subjective status to be determined by occupational position, education, household income, satisfaction with standard of living, and feeling of financial security regarding the future. The results suggest that subjective social status reflects the cognitive averaging of standard markers of socioeconomic situation and is free of psychological biases. [Copyright &y& Elsevier]

We sought to explain the observed variation in the relationship between education and cardiovascular disease (CVD) among young women in countries at different stages of economic development. Data comprised 2,478 cases of acute myocardial infarction (AMI) or stroke and 6,819 age-matched controls from Africa, Asia, Eastern Europe, and Latin America. The risks of AMI associated with lower education observed in Eastern Europe and higher education in non-European countries were reduced by 92% in Eastern Europe and totally abolished in non-European countries by adjustment for standard cardiovascular risk factors. The inverse associations between education and stroke risk in the three non-African regions were attenuated by 22, 47, and 60% after adjustment. In Africa, the slight inconsistent trend towards lower stroke risk in less well educated women was unaffected by adjustment. These data suggest that standard risk factors explain a substantial proportion if not all of the difference in AMI risk associated with education but a lesser proportion of educationally linked stroke risk. [Copyright &y& Elsevier]

Examines the effect of family structure, socioeconomic indicators, and parental working and psychological status on children's psychological health in England using multivariate logistic regression models. Great Britain's policy response to changes in family structure; Socioeconomic circumstances of single parents; Strengths and difficulties questionnaire.

Examines the effects of major organizational change and job insecurity on the health status of a cohort of 7419 white-collar civil servants in Great Britain. Details on the comparisons made on groups exposed to or anticipating exposure to this stressor; Discussion on the health related behavior in men as compared to women; Details on the wider consequence of job insecurity.