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. 2014 Dec;104(12):e98-e107.
doi: 10.2105/AJPH.2014.302156. Epub 2014 Oct 16.

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

Lisa B Signorello  1 , Sarah S Cohen, David R Williams, Heather M Munro, Margaret K Hargreaves, William J Blot
Affiliations

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

Lisa B Signorello et al. Am J Public Health. 2014 Dec.

Abstract

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.

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