Early-Life Sociodemographic Factors and Cardiovascular Health in Preadolescence Among Low-Income and Racially and Ethnically Diverse Children.

BACKGROUND: This study examined the relationship between early childhood sociodemographic factors, a subset of social determinants of health, and preadolescent cardiovascular health (CVH) among a cohort of children from low-income and racially and ethnically diverse households using the American Heart Association Life's Essential 8 (except sleep). METHODS: This secondary data analysis used data from the NET-Works (Now Everybody Together for Amazing and Healthful Kids) randomized controlled trial and NET-Works 2 at the U follow-up study. Children (n=268) were 2 to 4 years at enrollment and followed through preadolescence (7-11 years). Sociodemographic factors at baseline were exposures. The main outcome was the CVH score (high (≥80) versus lower (<80)), calculated using Life's Essential 8 factors measured at preadolescence. Modified Poisson regression models estimated risk ratios (RRs) and 95% CIs for the association between sociodemographic factors and CVH. RESULTS: In early childhood, living in households with an annual income of $35 000 to $64 999 (relative to <$15 000) (RR, 2.01 [95% CI, 1.3-3.0]), a parent with at least a bachelor's degree (RR, 2.1 [95% CI, 1.3-3.3]), enrollment in social security, disability, or unemployment (RR, 1.6 [95% CI, 1.0-2.4]), and Non-Hispanic White (RR, 2.2 [95% CI, 1.5-3.3]) were associated with high CVH in preadolescence. Among Life's Essential 8 factors, lower body mass index percentile and cholesterol, and higher physical activity levels and diet quality were most strongly associated with high CVH scores. CONCLUSIONS: Early-life disadvantaged sociodemographic factors were negatively associated with preadolescent CVH among children from low-income and racially and ethnically diverse households. Current public health prevention efforts to alleviate social disadvantage in early childhood are insufficient for long-term CVH. REGISTRATION: URL: https://clinicaltrials.gov; Unique identifier: NCT01606891.