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Race, socioeconomic status, and cause-specific mortality
G Howard1, R T Anderson, G Russell
1Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL 35294-0022, USA.
Annals of Epidemiology
|June 16, 2000
Summary
Socioeconomic status (SES) significantly explains racial disparities in mortality for Black Americans. SES accounts for a substantial portion of deaths from accidents, heart disease, diabetes, and homicide, particularly in women.
Area of Science:
- Public Health
- Epidemiology
- Sociomedical Sciences
Background:
- Black Americans experience a life expectancy 5-8 years shorter than White Americans.
- Socioeconomic status (SES) is lower for Black individuals and is linked to premature death.
Purpose of the Study:
- To quantify the proportion of racial differences in mortality attributed to SES across specific causes of death.
- To investigate the role of SES in explaining excess mortality among Black Americans.
Main Methods:
- Utilized data from the National Longitudinal Mortality Study (453,384 individuals).
- Estimated hazard ratios for Black race, adjusting for income and education (SES measures).
- Analyzed data across 38 strata defined by cause of death and age.
Main Results:
- For women, SES explained 37-67% of excess mortality for accidents, ischemic heart disease (ages 35-54), diabetes, and homicide.
- For men, SES explained 30-55% of excess mortality for accidents, lung cancer, stomach cancer, stroke, and homicide.
- SES explained a smaller proportion of deaths from hypertension, infections, stomach cancers (women), prostate cancer, pulmonary diseases, hypertension, and cardiomyopathy (men).
Conclusions:
- Identified specific causes of death underlying excess mortality in Black Americans.
- Highlighted the significant role of SES in explaining racial disparities for certain causes of death.