Socioeconomic Status, Race, and Mortality: A Prospective Cohort Study

• DOI: 10.2105/ajph.2014.302156
• Publication Date: 2014-10-16T20:01:55Z
• Authors: Lisa B. Signorello; Sarah S. Cohen; David R. Williams; Heather M. Munro; Margaret K. Hargr...; William J. Blot
• Keywords: Adult; Male; 1. No poverty; Middle Aged; United States; White People; 3. Good health; Black or African American; 03 medical and health sciences; 0302 clinical medicine; Social Class; Risk Factors; Humans; Female; Prospective Studies; Mortality; Aged; Demography

Objectives. We evaluated the independent and joint effects of race, individual socioeconomic status (SES), and neighborhood SES on mortality risk. Methods. 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. Results. 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. Conclusions. 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.