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Socioeconomic position, John Henryism, and incidence of acute myocardial infarction in Finnish men

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  • Mujahid, Mahasin S.
  • James, Sherman A.
  • Kaplan, George A.
  • Salonen, Jukka T.

Abstract

Previous cross-sectional studies examining whether John Henryism (JH), or high-effort coping with socioeconomic adversity, potentiates the inverse association between socioeconomic position (SEP) and cardiovascular health have focused mainly on hypertension in African Americans. We conducted the first longitudinal test of this hypothesis on incident acute myocardial infarction (AMI) using data from the Kuopio Ischemic Heart Disease Risk Factor Study in Finland (N = 1405 men, 42–60 years). We hypothesized that the expected inverse gradient between SEP and AMI risk would be stronger for men scoring high on JH than for those scoring low. John Henryism was measured by a Finnish version of the JH Scale for Active Coping. Four different measures of SEP were used: childhood SEP, education, income, and occupation. AMI hazard ratios (HR) by SEP and JH were estimated using COX proportional hazard models, before and after adjustment for study covariates. 205 cases of AMI occurred over a median of 14.9 years. Men employed in lower rank (farmer, blue-collar) occupations who scored high on JH had significantly higher age-adjusted risks of AMI than men in higher rank (white-collar) occupations (HR = 3.14, 95% CI: 1.65–5.98 for blue collar; HR = 2.33, 95% CI: 1.04–5.22 for farmers) who also scored high on JH. No socioeconomic differences in AMI were observed for men who scored low on JH (HR = 1.36, 95% CI: 0.74–2.47 for blue collar; HR = 0.93, 95% CI: 0.59–1.48 for farmers; p = 0.002 for the SEP × JH interaction). These findings persisted after adjustment for sociodemographic, behavioral, and biological factors. Results for other SEP measures were in the same direction, but did not reach statistical significance. Repetitive high-effort coping with adversity (John Henryism) was independently associated with increased risk for AMI in Finnish men, underscoring the potential relevance of the John Henryism hypothesis to CVD outcomes other than hypertension and to populations other than African Americans.

Suggested Citation

  • Mujahid, Mahasin S. & James, Sherman A. & Kaplan, George A. & Salonen, Jukka T., 2017. "Socioeconomic position, John Henryism, and incidence of acute myocardial infarction in Finnish men," Social Science & Medicine, Elsevier, vol. 173(C), pages 54-62.
    • Handle: RePEc:eee:socmed:v:173:y:2017:i:c:p:54-62
    DOI: 10.1016/j.socscimed.2016.11.034
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    References listed on IDEAS

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    1. Adler, Nancy & Singh-Manoux, Archana & Schwartz, Joseph & Stewart, Judith & Matthews, Karen & Marmot, Michael G., 2008. "Social status and health: A comparison of British civil servants in Whitehall-II with European- and African-Americans in CARDIA," Social Science & Medicine, Elsevier, vol. 66(5), pages 1034-1045, March.
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    3. Haritatos, Jana & Mahalingam, Ramaswami & James, Sherman A., 2007. "John Henryism, self-reported physical health indicators, and the mediating role of perceived stress among high socio-economic status Asian immigrants," Social Science & Medicine, Elsevier, vol. 64(6), pages 1192-1203, March.
    4. Lynch, J. & Krause, N. & Kaplan, G.A. & Tuomilehto, J. & Salonen, J.T., 1997. "Workplace conditions, socioeconomic status, and the risk of mortality and acute myocardial infarction: The Kuopio Ischemic Heart Disease Risk Factor Study," American Journal of Public Health, American Public Health Association, vol. 87(4), pages 617-622.
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