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Socioeconomic and behavioral risk factors for mortality in a national 19-year prospective study of U.S. adults

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  • Lantz, Paula M.
  • Golberstein, Ezra
  • House, James S.
  • Morenoff, Jeffrey

Abstract

Many demographic, socioeconomic, and behavioral risk factors predict mortality in the United States. However, very few population-based longitudinal studies are able to investigate simultaneously the impact of a variety of social factors on mortality. We investigated the degree to which demographic characteristics, socioeconomic variables and major health risk factors were associated with mortality in a nationally-representative sample of 3617 U.S. adults from 1986 to 2005, using data from the 4 waves of the Americans' Changing Lives study. Cox proportional hazard models with time-varying covariates were employed to predict all-cause mortality verified through the National Death Index and death certificate review. The results revealed that low educational attainment was not associated with mortality when income and health risk behaviors were included in the model. The association of low income with mortality remained after controlling for major behavioral risks. Compared to those in the "normal" weight category, neither overweight nor obesity was significantly associated with the risk of mortality. Among adults age 55 and older at baseline, the risk of mortality was actually reduced for those were overweight (hazard rate ratio = 0.83) and those who were obese (hazard rate ratio = 0.68), controlling for other health risk behaviors and health status. Having a low level of physical activity was a significant risk factor for mortality (hazard rate ratio = 1.58). The results from this national longitudinal study underscore the need for health policies and clinical interventions focusing on the social and behavioral determinants of health, with a particular focus on income security, smoking prevention/cessation, and physical activity.

Suggested Citation

  • Lantz, Paula M. & Golberstein, Ezra & House, James S. & Morenoff, Jeffrey, 2010. "Socioeconomic and behavioral risk factors for mortality in a national 19-year prospective study of U.S. adults," Social Science & Medicine, Elsevier, vol. 70(10), pages 1558-1566, May.
  • Handle: RePEc:eee:socmed:v:70:y:2010:i:10:p:1558-1566
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    References listed on IDEAS

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    Cited by:

    1. Florence Jusot & Sandy Tubeuf & Alain Trannoy, 2012. "Les différences d'état de santé en France : inégalités des chances ou reflet des comportements à risques ?," Économie et Statistique, Programme National Persée, vol. 455(1), pages 37-51.
    2. repec:dau:papers:123456789/9292 is not listed on IDEAS
    3. Shaw, Benjamin A. & McGeever, Kelly & Vasquez, Elizabeth & Agahi, Neda & Fors, Stefan, 2014. "Socioeconomic inequalities in health after age 50: Are health risk behaviors to blame?," Social Science & Medicine, Elsevier, vol. 101(C), pages 52-60.
    4. Hall, Taylor & Chassler, Deborah & Blom, Björn & Grahn, Robert & Blom-Nilsson, Marcus & Sullivan, Lisa & Lundgren, Lena, 2015. "Mortality among a national population sentenced to compulsory care for substance use disorders in Sweden: Descriptive study," Evaluation and Program Planning, Elsevier, vol. 49(C), pages 153-162.
    5. Bruce Hollingsworth & Anthony Scott & Sandy Tubeuf & Florence Jusot & Damien Bricard, 2012. "Mediating Role Of Education And Lifestyles In The Relationship Between Early‐Life Conditions And Health: Evidence From The 1958 British Cohort," Health Economics, John Wiley & Sons, Ltd., vol. 21, pages 129-150, June.
    6. Bruce Hollingsworth & Anthony Scott & Sandy Tubeuf & Florence Jusot & Damien Bricard, 2012. "Mediating Role Of Education And Lifestyles In The Relationship Between Early‐Life Conditions And Health: Evidence From The 1958 British Cohort," Health Economics, John Wiley & Sons, Ltd., vol. 21, pages 129-150, June.
    7. Jeffrey T. Howard & P. Johnelle Sparks, 2016. "The Effects of Allostatic Load on Racial/Ethnic Mortality Differences in the United States," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 35(4), pages 421-443, August.
    8. Elwell-Sutton, Timothy M. & Jiang, Chao Qiang & Zhang, Wei Sen & Cheng, Kar Keung & Lam, Tai Hing & Leung, Gabriel M. & Schooling, C.M., 2011. "Socioeconomic influences at different life stages on health in Guangzhou, China," Social Science & Medicine, Elsevier, vol. 72(11), pages 1884-1892, June.
    9. Zheng, Hui & Yang, Yang, 2012. "Population heterogeneity in the impact of body weight on mortality," Social Science & Medicine, Elsevier, vol. 75(6), pages 990-996.
    10. Hayward, R. David & Krause, Neal, 2014. "The effect of belonging to an alcohol-proscribing religious group on the relationship between moderate alcohol consumption and mortality," Social Science & Medicine, Elsevier, vol. 101(C), pages 1-8.

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