Impacts of mid- to later childhood body build, social circumstance and blood pressure on early-adult arterial stiffness in different ethnic groups

OBJECTIVE: Arterial stiffness, measured as aortic pulse wave velocity [PWV], is a powerful prognostic indicator for cardiovascular events, displacing blood pressure (BP). Little is known of its determinants. We tested how factors measured twice previously in childhood in the MRC ‘DASH’ study, particularly body mass (BMI) components and BP, affected PWV in young adults. DESIGN AND METHODS: Of 6643 London children, aged 11-13y, from 51 schools in samples of about 1000 in 6 ethnic groups, 4785 (72% of the cohort), were seen again at 14-16y. In 2013, 666 (97% of invited) took part in a young-adult pilot (21-23y). With psychosocial, anthropometric and BP measures, PWV was recorded via an upper arm cuff on the calibrated Arteriograph device. RESULTS: PWV reproducibility was excellent, with mean differences across 3 x 6-8 cardiac cycles each of -0.06, 0.03 and 0.06 m/sec. Unadjusted PWVs in Caribbean-origin and White UK young men were similar (mean+SD 7.9+0.3 vs 7.6 +0.4 m/sec) and lower in other groups at similar SBPs (120mmHg), BMIs (24.6kg/m2) and waists (84.3cm). In full regression models, while Caribbean (higher BMIs and waists), African and Indian young women had lower PWV (by 0.5-0.8, 95%CI 0.1-1.1,m/sec) than did white UK women (6.9+0.2), values were still increased by age, BP, a powerful impact from waist/height, with a racism effect (+0.4m/sec) in women. Childhood effects of waist/hip were also detectable. CONCLUSION: Even by young adulthood, increased waist/height ratios, BP and psychosocial variables such as perceived racism were independent determinants of arterial stiffness, likely to increase with age.

The determinants of young adult social well-being and health (DASH) study: the influence of parenting and religious involvement on mental health

OBJECTIVE: The DASH longitudinal study found better mental health for ethnic minorities compared to White British adolescents in the UK, despite more disadvantage. This paper investigates the impact of parenting style and attendance at a place of worship on mental well-being from adolescence to young adulthood. DESIGN AND METHODS: In 2002/03, 6643 11-13 year olds in London, ~80% ethnic minorities, participated in the baseline survey. In 2005/06 4,782 were followed-up. In 2012-14 665 took part in a pilot follow-up aged 21-23y, including 42 qualitative interviews. Measures of socio- economic and psychosocial factors and health were collected. RESULTS: In adolescence, ethnic minorities generally experienced more adversity but reported better mental health. Regardless of ethnicity, low parental care vs. high parental care (e.g. males coefficient: 1.32, 95% confidence interval 0.94-1.70), high parental control vs. low parental control (males: 1.37, 1.00-1.74), and attendance to a place of worship vs. no attendance were independently associated with mental health. At 21-23y, the ethnic patterning of mental health appeared to track, with increasing parental care, but not religious involvement, continuing to have a protective effect on mental health. Education levels signalled potential for socio-economic parity across ethnic groups, and family support appeared to reduce stress of transitions to adulthood. CONCLUSIONS: DASH provides evidence for a protective effect from parenting styles and religious involvement for young people growing up in ethnically diverse and deprived urban contexts. This suggests the value of cultural and social resources for psychological well- being.

Racism triggers smoking in British ethnic minority adolescents: evidence from the determinants of young adult social wellbeing and health (DASH) longitudinal study

OBJECTIVE: Racism may have a negative impact on the health behaviours in adolescence, however there were few longitudinal studies. We examined the impact of perceived racism on smoking in an ethnically diverse sample of adolescents in the UK, and potential modifying factors. DESIGN AND METHODS: In 2002/03, 6643 11-13 year olds in London, ~80% ethnic minorities, participated in the baseline survey. In 2005/06 4,782 were followed-up. In 2012-14 665 took part in a pilot follow-up aged 21-23y, including 42 qualitative interviews. Measures of socio- economic and psychosocial factors and health were collected. RESULTS: Ethnic minority adolescents were more likely to report racism compared with White British, but smoking was generally lower. Reported racism in adolescence was associated with having ever smoked (e.g. males Odds Ratio 2.20, 95% CI 1.59-3.02), and with smoking initiation (males 4.09, 2.45-6.83). Smoking initiation was greatest among Black Caribbeans. Attendance to a place of worship, being a Muslim and a good parent-child relationship were independent protective factors. Qualitative interviews supported evidence for reported racism as well as protective factors including increasing ethnic diversity, a sense of identity and belonging, supportive parenting, high aspirations, and religious faith. CONCLUSIONS: This is the first UK study to show the negative impact of racism on smoking in adolescence, regardless of ethnic origin. Religious involvement and parenting may provide social support and reinforce cultural and religious values which may prevent the uptake of harmful health behaviours such as smoking. This has implications for health promotion among young people of all ethnicities.