Socioeconomic position and premature mortality in the AusDiab cohort of Australian adults

Hélène Bihan, Kathrin Backholer, Anna Peeters, Christopher E. Stevenson, Jonathan E. Shaw, Dianna J. Magliano

Research output: Contribution to journalArticleResearchpeer-review

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 disadvantaged (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.

Original languageEnglish
Pages (from-to)470-477
Number of pages8
JournalAmerican Journal of Public Health
Volume106
Issue number3
DOIs
Publication statusPublished - Mar 2016

Cite this

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title = "Socioeconomic position and premature mortality in the AusDiab cohort of Australian adults",
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 disadvantaged (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.",
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Socioeconomic position and premature mortality in the AusDiab cohort of Australian adults. / Bihan, Hélène; Backholer, Kathrin; Peeters, Anna; Stevenson, Christopher E.; Shaw, Jonathan E.; Magliano, Dianna J.

In: American Journal of Public Health, Vol. 106, No. 3, 03.2016, p. 470-477.

Research output: Contribution to journalArticleResearchpeer-review

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N2 - 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 disadvantaged (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.

AB - 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 disadvantaged (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.

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