Socioeconomic status, race, and mortality: a prospective cohort study

• Published in: American journal of public health (1971) 2014-12, Vol.104 (12), p.e98-e107
• Main Authors: Signorello, Lisa B, Cohen, Sarah S, Williams, David R, Munro, Heather M, Hargreaves, Margaret K, Blot, William J
• Format: Article
• Language: English
• Subjects: Adult; African Americans; African Americans/Blacks; Aged; Black or African American - statistics & numerical data; Censuses; Cohort analysis; Community colleges; Demography; Enrollments; Epidemiology; Ethnicity; Family income; Female; Health facilities; Health insurance; Health services; Hispanic people; Households; Humans; Insurance coverage; Low income groups; Male; Middle Aged; Mortality; Mortality - trends; Neighborhoods; Online Research and Practice; Other Race/Ethnicity; Population; Principal components analysis; Prospective Studies; Public health; Race; Risk Factors; Social Class; Social security; Socioeconomic Factors; Studies; United States - epidemiology; Variables; White people; White People - statistics & numerical data; Women
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/ajph.2014.302156

We evaluated the independent and joint effects of race, individual socioeconomic status (SES), and neighborhood SES on mortality risk. We conducted a prospective analysis involving 52 965 non-Hispanic Black and 23 592 non-Hispanic White adults taking part in the Southern Community Cohort Study. Cox proportional hazards modeling was used to determine associations of race and SES with all-cause and cause-specific mortality. In our cohort, wherein Blacks and Whites had similar individual SES, Blacks were less likely than Whites to die during the follow-up period (hazard ratio [HR] = 0.78; 95% confidence interval [CI] = 0.73, 0.84). Low household income was a strong predictor of all-cause mortality among both Blacks and Whites (HR = 1.76; 95% CI = 1.45, 2.12). Being in the lowest (vs highest) category with respect to both individual and neighborhood SES was associated with a nearly 3-fold increase in all-cause mortality risk (HR = 2.76; 95% CI = 1.99, 3.84). There was no significant mortality-related interaction between individual SES and neighborhood SES among either Blacks or Whites. SES is a strong predictor of premature mortality, and the independent associations of individual SES and neighborhood SES with mortality risk are similar for Blacks and Whites.