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- Title
Socioeconomic Position and Premature Mortality in the AusDiab Cohort of Australian Adults.
- Authors
Bihan, Helene; Backholer, Kathrin; Peeters, Anna; Stevenson, Christopher E.; Shaw, Jonathan E.; Magliano, Dianna J.
- Abstract
Objectives. To determine the association of socioeconomic position indicators with mortality, without and with adjustment for modifiable risk factors. Methods. We examined the relationships of 2 area-based indices and educational level with mortality among 9338 people (including 8094 younger than 70 years at baseline) of the Australian Diabetes Obesity and Lifestyle (AusDiab) from 1999-2000 until November 30, 2012. Results. Age- and gender-adjusted premature mortality (death before age 70 years) was more likely among those living in the most disadvantaged areas versus least dis-advantaged (hazard ratio [HR] = 1.48; 95% confidence interval [CI] = 1.08, 2.01), living in inner regional versus major urban areas (HR= 1.36; 95% CI = 1.07, 1.73), or having the lowest educational level versus the highest (HR=1.64; 95% CI = 1.17, 2.30). The contribution of modifiable risk factors (smoking status, diet quality, physical activity, stress, cardiovascular risk factors) in the relationship between 1 area-based index or educational level and mortality was more apparent as age of death decreased. Conclusions. The relation of area-based socioeconomic position to premature mortality is partly mediated by behavioral and cardiovascular risk factors. Such results could influence public health policies.
- Subjects
AUSTRALIA; HEALTH &; social status; EARLY death; HEALTH of adults; COHORT analysis; DIABETES; AUSTRALIANS; MORTALITY; EDUCATIONAL attainment; DEATH rate; OBESITY; HEALTH; CHI-squared test; CONFIDENCE intervals; POPULATION geography; RESEARCH funding; SOCIOECONOMIC factors; HEALTH equity; PROPORTIONAL hazards models; SEDENTARY lifestyles; DATA analysis software; DESCRIPTIVE statistics; ODDS ratio
- Publication
American Journal of Public Health, 2016, Vol 106, Issue 3, p470
- ISSN
0090-0036
- Publication type
Article
- DOI
10.2105/AJPH.2015.302984