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Background - Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis is hypothesized to be an important pathway linking socioeconomic position and chronic disease.

Purpose - This paper tests the association between education and the diurnal rhythm of salivary control.

Methods - Up to 8 measures of cortisol (mean of 5.38 per respondent) over two days were obtained from 311 respondents aged 18-70, drawn from 2001-2002 Chicago Community Adult Health Study. Multi-level models with linear splines were used to estimate waking level, rates of cortisol decline, and area-under-the-curve over the day, by categories of education.

Results - Lower education (0-11 years) was associated with lower waking levels of cortisol, but not the rate of decline of cortisol, resulting in a higher area-under-the-curve for more educated respondents throughout the day.

Conclusions - This study found evidence of lower cortisol exposure among individuals with less education and thus does not support the hypothesis that less education is associated with chronic over-exposure to cortisol.


Dowd, J. B., Ranjit, N., Do, D. P., Young, E. A., House, J. S., & Kaplan, G. A. (2011). Education and levels of salivary cortisol over the day in US adults. Annals of Behavioral Medicine, 41(1), 13-20.

DOI: 10.1007/s12160-010-9224-2

© Annals of Behavioral Medicine, 2011, Springer Verlag

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