PMID- 27770781
OWN - NLM
STAT- MEDLINE
DCOM- 20170807
LR  - 20240326
IS  - 1471-2458 (Electronic)
IS  - 1471-2458 (Linking)
VI  - 16
IP  - 1
DP  - 2016 Oct 22
TI  - Racial disparities in adult all-cause and cause-specific mortality among us 
      adults: mediating and moderating factors.
PG  - 1113
LID - 1113
AB  - 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.
FAU - Beydoun, M A
AU  - Beydoun MA
AD  - NIH Biomedical Research Center, National Institute on Aging, IRP, 251 Bayview 
      Blvd. Suite 100 Room #:04B118, Baltimore, MD, 21224, USA. baydounm@mail.nih.gov.
FAU - Beydoun, H A
AU  - Beydoun HA
AD  - Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, 
      MD, USA.
FAU - Mode, N
AU  - Mode N
AD  - NIH Biomedical Research Center, National Institute on Aging, IRP, 251 Bayview 
      Blvd. Suite 100 Room #:04B118, Baltimore, MD, 21224, USA.
FAU - Dore, G A
AU  - Dore GA
AD  - NIH Biomedical Research Center, National Institute on Aging, IRP, 251 Bayview 
      Blvd. Suite 100 Room #:04B118, Baltimore, MD, 21224, USA.
FAU - Canas, J A
AU  - Canas JA
AD  - Pediatric Endocrinology, Diabetes and Metabolism Nemours Children's Clinic, 
      Jacksonville, FL, USA.
FAU - Eid, S M
AU  - Eid SM
AD  - Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, 
      MD, USA.
FAU - Zonderman, A B
AU  - Zonderman AB
AD  - NIH Biomedical Research Center, National Institute on Aging, IRP, 251 Bayview 
      Blvd. Suite 100 Room #:04B118, Baltimore, MD, 21224, USA.
LA  - eng
PT  - Journal Article
DEP - 20161022
PL  - England
TA  - BMC Public Health
JT  - BMC public health
JID - 100968562
SB  - IM
MH  - Adult
MH  - Aged
MH  - Allostasis
MH  - Cardiovascular Diseases/*mortality
MH  - Cause of Death
MH  - Diet
MH  - Educational Status
MH  - *Ethnicity
MH  - Female
MH  - *Health Status Disparities
MH  - Humans
MH  - Income
MH  - Male
MH  - Middle Aged
MH  - Neoplasms/*mortality
MH  - Nutrition Surveys
MH  - *Poverty
MH  - Proportional Hazards Models
MH  - Prospective Studies
MH  - *Racial Groups
MH  - Risk
MH  - *Social Class
MH  - United States/epidemiology
MH  - Young Adult
PMC - PMC5075398
OTO - NOTNLM
OT  - Adult mortality
OT  - Cancer
OT  - Cardiovascular disease
OT  - Race/ethnicity
OT  - Socio-economic status
EDAT- 2016/10/25 06:00
MHDA- 2017/08/08 06:00
PMCR- 2016/10/22
CRDT- 2016/10/25 06:00
PHST- 2016/07/16 00:00 [received]
PHST- 2016/10/05 00:00 [accepted]
PHST- 2016/10/25 06:00 [pubmed]
PHST- 2017/08/08 06:00 [medline]
PHST- 2016/10/25 06:00 [entrez]
PHST- 2016/10/22 00:00 [pmc-release]
AID - 10.1186/s12889-016-3744-z [pii]
AID - 3744 [pii]
AID - 10.1186/s12889-016-3744-z [doi]
PST - epublish
SO  - BMC Public Health. 2016 Oct 22;16(1):1113. doi: 10.1186/s12889-016-3744-z.