Non-Hispanic Black adults had a significantly higher risk of all-cause mortality compared to Non-Hispanic White adults (HR 1.44), which was partly explained by socioeconomic and health-related factors.
Cohort (n=16,573)
Effect estimate: HR 1.44 (95% CI 1.31-1.58)
p-value: p=<0.001
BACKGROUND: Studies uncovering factors beyond socio-economic status (SES) that would explain racial and ethnic disparities in mortality are scarce. METHODS: Using prospective cohort data from the Third National Health and Nutrition Examination Survey (NHANES III), we examined all-cause and cause-specific mortality disparities by race, mediation through key factors and moderation by age (20-49 vs. 50+), sex and poverty status. Cox proportional hazards, discrete-time hazards and competing risk regression models were conducted (N = 16,573 participants, n = 4207 deaths, Median time = 170 months (1-217 months)). RESULTS: Age, sex and poverty income ratio-adjusted hazard rates were higher among Non-Hispanic Blacks (NHBs) vs. Non-Hispanic Whites (NHW). Within the above-poverty young men stratum where this association was the strongest, the socio-demographic-adjusted HR = 2.59, p < 0.001 was only partially attenuated by SES and other factors (full model HR = 2.08, p = 0.003). Income, education, diet quality, allostatic load and self-rated health, were among key mediators explaining NHB vs. NHW disparity in mortality. The Hispanic paradox was observed consistently among women above poverty (young and old). NHBs had higher CVD-related mortality risk compared to NHW which was explained by factors beyond SES. Those factors did not explain excess risk among NHB for neoplasm-related death (fully adjusted HR = 1.41, 95 % CI: 1.02-2.75, p = 0.044). Moreover, those factors explained the lower risk of neoplasm-related death among MA compared to NHW, while CVD-related mortality risk became lower among MA compared to NHW upon multivariate adjustment. CONCLUSIONS: In sum, racial/ethnic disparities in all-cause and cause-specific mortality (particularly cardiovascular and neoplasms) were partly explained by socio-demographic, SES, health-related and dietary factors, and differentially by age, sex and poverty strata.
Beydoun et al. (Sat,) conducted a cohort in All-cause and cause-specific mortality (n=16,573). Non-Hispanic Black race vs. Non-Hispanic White race was evaluated on All-cause mortality (adjusted for age, sex, and poverty income ratio) (HR 1.44, 95% CI 1.31-1.58, p=<0.001). Non-Hispanic Black adults had a significantly higher risk of all-cause mortality compared to Non-Hispanic White adults (HR 1.44), which was partly explained by socioeconomic and health-related factors.