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Allostatic Load, Educational Attainment, and Risk of Cancer Mortality Among US Men.

Cynthia Li1,2, Sydney P Howard1, Charles R Rogers3

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Men with less than a high school education and high allostatic load (chronic stress) face a significantly increased risk of cancer mortality. Addressing educational attainment and social determinants of health is crucial for reducing cancer disparities.

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Area of Science:

  • Public Health
  • Epidemiology
  • Social Determinants of Health

Background:

  • Health disparities in cancer mortality persist among racial and ethnic minority men.
  • Chronic stress, indicated by allostatic load, and limited educational opportunities are linked to elevated cancer risks.
  • Discrimination contributes to these complex health associations in underrepresented populations.

Purpose of the Study:

  • To investigate the relationship between educational attainment, allostatic load, and cancer mortality risk in men.
  • To quantify the impact of chronic stress and education level on cancer death rates.

Main Methods:

  • Retrospective cohort analysis using National Health and Nutrition Examination Survey (1988-2010) and National Death Index data.
  • Inclusion of 20,529 men aged 18+; allostatic load stratified by educational attainment (less than high school vs. high school graduate and above).
  • Weighted Cox proportional hazards models used to assess cancer death risk, adjusting for covariates like age, income, and smoking status.

Main Results:

  • Men with high allostatic load and less than a high school education had over a 4-fold increased risk of cancer mortality.
  • This association remained significant after adjusting for multiple factors, with increased risks observed for all men and White men specifically.
  • Both Black and White men with lower education and high allostatic load showed elevated cancer death risks compared to counterparts with higher education and lower allostatic load.

Conclusions:

  • Lower educational attainment combined with high allostatic load significantly increases cancer mortality risk in men.
  • These findings underscore the detrimental impact of chronic stress and limited education on cancer outcomes.
  • Interventions promoting education and addressing social determinants of health are essential for mitigating cancer disparities.