OBJECTIVES: This study examined the role of behavioral and material factors in explaining educational differences in all-cause mortality, taking into account the overlap between both types of factors. METHODS: Prospective data were used on 15,451 participants in a Dutch longitudinal study. Relative hazards of all-cause mortality by educational level were calculated before and after adjustment for behavioral factors (alcohol intake, smoking, body mass index, physical activity, dietary habits) and material factors (financial problems, neighborhood conditions, housing conditions, crowding, employment status, a proxy of income). RESULTS: Mortality was higher in lower educational groups. Four behavioral factors (alcohol, smoking, body mass index, physical activity) and 3 material factors (financial problems, employment status, income proxy) explained part of the educational differences in mortality. With the overlap between both types of factors accounted for, material factors were more important than behavioral factors in explaining mortality differences by educational level. CONCLUSIONS: The association between educational level and mortality can be largely explained by material factors. Thus, improving the material situation of people might substantially reduce educational differences in mortality.
OBJECTIVES: This study examined the role of behavioral and material factors in explaining educational differences in all-cause mortality, taking into account the overlap between both types of factors. METHODS: Prospective data were used on 15,451 participants in a Dutch longitudinal study. Relative hazards of all-cause mortality by educational level were calculated before and after adjustment for behavioral factors (alcohol intake, smoking, body mass index, physical activity, dietary habits) and material factors (financial problems, neighborhood conditions, housing conditions, crowding, employment status, a proxy of income). RESULTS: Mortality was higher in lower educational groups. Four behavioral factors (alcohol, smoking, body mass index, physical activity) and 3 material factors (financial problems, employment status, income proxy) explained part of the educational differences in mortality. With the overlap between both types of factors accounted for, material factors were more important than behavioral factors in explaining mortality differences by educational level. CONCLUSIONS: The association between educational level and mortality can be largely explained by material factors. Thus, improving the material situation of people might substantially reduce educational differences in mortality.
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Keywords:
Alcohol Drinking; Behavior; Biology; Body Weight; Demographic Factors; Developed Countries; Diet; Differential Mortality; Economic Factors; Educational Status; Employment Status; Europe; Financial Activities; Geographic Factors; Health; Housing; Income; Mortality; Netherlands; Nutrition; Physiology; Population; Population Dynamics; Residence Characteristics; Smoking; Socioeconomic Factors; Socioeconomic Status; Spatial Distribution; Western Europe
Authors: J A A Dalstra; A E Kunst; J J M Geurts; F J M Frenken; J P Mackenbach Journal: J Epidemiol Community Health Date: 2002-12 Impact factor: 3.710
Authors: Mark Lemstra; Norman R Bennett; Cory Neudorf; Anton Kunst; Ushasri Nannapaneni; Lynne M Warren; Tanis Kershaw; Christina R Scott Journal: Can J Public Health Date: 2008 May-Jun
Authors: S Shohaimi; R Luben; N Wareham; N Day; S Bingham; A Welch; S Oakes; K-T Khaw Journal: J Epidemiol Community Health Date: 2003-04 Impact factor: 3.710