{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:18:25Z","timestamp":1792113505491,"version":"4.4.0"},"reference-count":86,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,12,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Cardiovascular disease (CVD) remains a leading cause of death for women in the United States, with veterans being at potentially higher risk than their nonveteran counterparts due to accelerated aging and distinct biopsychosocial mechanisms. We examined pathways between selected indicators of socioeconomic status (SES) such as education, occupation, household income, and neighborhood SES and major CVD events through lifestyle and health characteristics among veteran and nonveteran postmenopausal women.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A total of 121\u2009286 study\u2010eligible WHI (Women's Health Initiative) participants (3091 veterans and 118\u2009195 nonveterans) were prospectively followed for an average of 17\u2009years, during which 16\u2009108 major CVD events were documented. Using generalized structural equations modeling coupled with survival analysis techniques, we estimated the effects of SES on major CVD events through smoking, body mass index, comorbidities, cardiometabolic risk factors, and self\u2010rated health, controlling for WHI component, region, age, race, ethnicity, marital status, and health care provider access. Among veterans, SES characteristics were indirectly related to major CVD events through body mass index, comorbidities, cardiometabolic risk factors, and self\u2010rated health. Among nonveterans, lower education (\u03b2=\u20090.2,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001), household income (\u03b2=+0.4,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001), and neighborhood SES (\u03b2=+0.2,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001) were positively related to major CVD events, and these relationships were partly mediated by body mass index, comorbidities, cardiometabolic risk factors, and self\u2010rated health. Smoking played a mediating role only among nonveterans.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Nonveteran postmenopausal women exhibit more complex pathways between SES and major CVD events than their veteran counterparts, informing the design, conduct, and evaluation of preventive strategies targeting CVD by veteran status.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.037253","type":"journal-article","created":{"date-parts":[[2024,12,14]],"date-time":"2024-12-14T09:55:32Z","timestamp":1734170132000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Pathways From Socioeconomic Factors to Major Cardiovascular Events Among Postmenopausal Veteran and Nonveteran Women: Findings From the Women's Health Initiative"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9704-328X","authenticated-orcid":false,"given":"Hind A.","family":"Beydoun","sequence":"first","affiliation":[{"name":"VA National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs Washington DC USA"},{"name":"Department of Management, Policy, and Community Health, School of Public Health University of Texas Health Science Center at Houston Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1050-4523","authenticated-orcid":false,"given":"May A.","family":"Beydoun","sequence":"additional","affiliation":[{"name":"Laboratory of Epidemiology and Population Sciences National Institute on Aging Intramural Research Program Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6752-5715","authenticated-orcid":false,"given":"Rebecca L.","family":"Kinney","sequence":"additional","affiliation":[{"name":"VA National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs Washington DC USA"},{"name":"VA Central Western Massachusetts Healthcare System Leeds MA USA"},{"name":"Department of Population and Quantitative Health Sciences University of Massachusetts Medical School Worcester MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2098-3844","authenticated-orcid":false,"given":"Simin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health Brown University Providence RI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0004-4136","authenticated-orcid":false,"given":"Rona","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Medicine Uniformed Services University Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0777-8272","authenticated-orcid":false,"given":"Matthew","family":"Allison","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, School of Medicine University of California at San Diego San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert B.","family":"Wallace","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, College of Public Health University of Iowa Iowa City IA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8388-1178","authenticated-orcid":false,"given":"Qian","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health University of Texas Health Science Center at Houston Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Longjian","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Dornsife School of Public Health Drexel University Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5225-1184","authenticated-orcid":false,"given":"Philippe","family":"Gradidge","sequence":"additional","affiliation":[{"name":"Department of Exercise Science &amp; 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