Background
Methods
Study population
Mortality outcome
Main predictors
Exogenous variables
Potential mediators
Socio-economic status
Lifestyle and social support factors
Health-related factors
Statistical analysis
Result
Study sample characteristics by race/ethnicity group
Race/ethnicity | |||||
---|---|---|---|---|---|
Selected participant characteristics | NHW | NHB | MA | p-value (Design-based F-test)b | |
Unweighted N | (N = 7221) 82.9 % | (N = 4846) 11.9 % | (N = 4506) 5.2 % | NHB vs. NHW | Mexican-American vs. NHW |
Socio-demographic characteristics
| |||||
Age (years) | 45.5 ± 0.5 | 42.0 ± 0.4 | 37.6 ± 0.4 | <0.001 | <0.001 |
20–49 | 63.1 ± 1.3 | 70.8 ± 1.3 | 80.6 ± 0.9 | <0.001 | <0.001 |
50+ | 36.9 ± 1.3 | 29.2 ± 1.3 | 19.4 ± 0.9 | ||
Sex, % male | 47.9 ± 0.5 | 43.7 ± 0.9 | 52.0 ± 0.7 | <0.001 | <0.001 |
Urban/rural area of residence | |||||
Urban | 46.5 ± 4.9 | 59.1 ± 5.6 | 61.4 ± 6.1 | 0.011 | 0.020 |
Rural | 53.5 ± 4.9 | 40.9 ± 5.6 | 38.6 ± 6.1 | ||
Household size | 2.82 ± 0.04 | 3.23 ± 0.07 | 4.33 ± 0.10 | <0.001 | <0.001 |
Marital status | |||||
Never married | 14.5 ± 0.9 | 28.2 ± 1.1 | 17.7 ± 1.1 | <0.001 | 0.008 |
Married | 64.0 ± 1.0 | 36.1 ± 1.1 | 60.4 ± 1.3 | __ | |
Divorced | 8.0 ± 0.4 | 11.9 ± 0.8 | 4.7 ± 0.6 | <0.001 | 0.003 |
Widowed | 7.2 ± 0.4 | 8.8 ± 0.5 | 3.5 ± 0.4 | <0.001 | <0.001 |
Other | 6.3 ± 0.4 | 15.0 ± 0.6 | 13.8 ± 1.2 | <0.001 | <0.001 |
Socio-economic status
| |||||
Poverty income ratio | 3.28 ± 0.06 | 2.02 ± 0.06 | 1.77 ± 0.05 | <0.001 | <0.001 |
Education, years | 12.7 ± 0.1 | 11.5 ± 0.1 | 9.0 ± 0.2 | <0.001 | <0.001 |
Insurance status | |||||
Insured | 93.8 ± 1.1 | 90.7 ± 2.0 | 78.9 ± 4.7 | 0.034 | <0.001 |
Uninsured | 6.2 ± 1.1 | 9.3 ± 2.0 | 21.1 ± 4.7 | ||
Substance abuse
| |||||
Illicit drug use | |||||
Never | 63.0 ± 1.4 | 59.8 ± 1.3 | 70.6 ± 1.3 | 0.025 | <0.001 |
Ever | 37.0 ± 1.4 | 40.2 ± 1.3 | 29.4 ± 1.4 | ||
Alcohol, g/d | 9.3 ± 0.5 | 8.8 ± 0.4 | 8.9 ± 0.6 | 0.37 | 0.59 |
Nutritional factors
| |||||
1995-HEI total score | 64.3 ± 0.3 | 59.5 ± 0.3 | 63.9 ± 0.5 | <0.001 | 0.39 |
MAR total score | 74.2 ± 0.3 | 67.9 ± 0.4 | 73.7 ± 0.4 | <0.001 | 0.33 |
Physical activity 0 = Less, 1 = Same, 2 = more
| |||||
Compare activity for past mo to past yr | 0.87 ± 0.01 | 0.91 ± 0.01 | 0.88 ± 0.02 | 0.049 | 0.74 |
Active compared with men/women your age | 1.13 ± 0.01 | 1.06 ± 0.01 | 1.01 ± 0.02 | <0.001 | <0.001 |
Active now compared with self 10 year ago | 0.61 ± 0.02 | 0.60 ± 0.01 | 0.66 ± 0.02 | 0.50 | 0.09 |
Smoking
| |||||
# cigarettes/day | 10.67 ± 0.27 | 6.68 ± 0.18 | 5.19 ± 0.15 | <0.001 | <0.001 |
Years smoked cigarettes | 7.81 ± 0.19 | 6.16 ± 0.17 | 5.03 ± 0.17 | <0.001 | <0.001 |
Social support
| |||||
(1) In a typical week, how many times do you talk on the telephone with family, friends, or neighbors? | 10.2 ± 0.2 | 12.8 ± 0.6 | 6.9 ± 0.3 | <0.001 | <0.001 |
(2) How often do you get together with friends or relatives; I mean things like going out together or visiting in each other's homes? (per year) | 118.3 ± 2.6 | 136.9 ± 4.2 | 108.1 ± 3.8 | <0.001 | <0.001 |
(3) About how often do you visit with any of your other neighbors, either in their homes or in your own? (per year) | 65.9 ± 3.0 | 79.3 ± 5.0 | 54.2 ± 3.4 | 0.013 | 0.024 |
(4) How often do you attend church or religious services? (per year) | 30.2 ± 1.1 | 37.3 ± 2.4 | 33.3 ± 1.9 | 0.013 | 0.13 |
(5) Altogether, how often do you attend meetings of the clubs or organizations (per year) | 13.9 ± 0.6 | 11.9 ± 0.7 | 6.6 ± 0.4 | 0.020 | <0.001 |
Health-related factors
| |||||
Self-rated health | |||||
Excellent/Very Good | 54.6 ± 1.2 | 38.1 ± 1.4 | 28.1 ± 0.9 | <0.001 | <0.001 |
Good | 31.6 ± 0.8 | 38.1 ± 0.9 | 40.2 ± 1.1 | ||
Fair/Poor | 13.8 ± 0.8 | 23.7 ± 1.1 | 31.7 ± 1.2 | ||
Co-morbidity index | 0.80 ± 0.02 | 0.60 ± 0.02 | 0.37 ± 0.01 | <0.001 | <0.001 |
Allostatic load, AL score | 1.77 ± 0.04 | 1.97 ± 0.05 | 1.84 ± 0.05 | 0.001 | 0.30 |
AL components
| |||||
Low Albumin | 9.6 ± 1.0 | 19.6 ± 1.5 | 9.9 ± 0.8 | <0.001 | 0.75 |
High CRP | 27.2 ± 1.3 | 37.9 ± 1.4 | 31.9 ± 1.9 | <0.001 | 0.034 |
High waist-hip ratio | 63.4 ± 0.9 | 57.5 ± 1.3 | 72.2 ± 0.8 | <0.001 | <0.001 |
High total cholesterol | 20.2 ± 0.7 | 17.1 ± 0.7 | 15.2 ± 1.1 | 0.004 | 0.001 |
Low HDL-C | 24.2 ± 0.9 | 16.0 ± 0.9 | 26.1 ± 1.3 | <0.001 | 0.23 |
High glycated hemoglobin | 5.1 ± 0.4 | 10.8 ± 0.6 | 7.5 ± 0.5 | <0.001 | 0.001 |
High resting heart rate | 6.4 ± 0.4 | 8.4 ± 0.6 | 5.7 ± 0.6 | 0.005 | 0.33 |
High systolic blood pressure | 15.8 ± 0.8 | 18.8 ± 0.7 | 10.5 ± 0.5 | 0.002 | <0.001 |
High diastolic blood pressure | 5.9 ± 0.4 | 11.1 ± 0.6 | 5.4 ± 0.4 | <0.001 | 0.42 |
Cause of death structure by race/ethnicity
Race/ethnicity and all-cause adult mortality: moderation by sex, age group and poverty status
Model 0: Crudeb | Model 1: sociodemographic factor-adjustedc | |||||
---|---|---|---|---|---|---|
Loge(HR) | 95 % CI |
P
| Loge(HR) | 95 % CI |
P
| |
<50y, women, PIR ≥ 125 %
d
|
(N = 3105)
|
(N = 3105)
| ||||
NHB vs. NHW | +0.12 | (-0.33;+0.58) | 0.60 | −0.07 | (-0.59;+0.46) | 0.81 |
MA vs. NHW | −0.26 | (-0.84;+0.32) | 0.37 | −0.21 | (-0.84;+0.42) | 0.43 |
<50y, men, PIR ≥ 125 %
d
|
(N = 2860)
|
(N = 2860)
| ||||
NHB vs. NHW | +0.87 | (+0.50;+1.24) | <0.001 | +0.95 | (+0.55;+1.34) | <0.001 |
MA vs. NHW | +0.22 | (-0.26;+0.70) | 0.37 | +0.49 | (-0.00;+0.99) | <0.001 |
<50y, women, PIR < 125 %
d
|
(N = 1728)
|
(N = 1728)
| ||||
NHB vs. NHW | +0.34 | (-0.55;+1.24) | 0.44 | +0.45 | (-0.43;+1.32) | 0.31 |
MA vs. NHW | −0.20 | (-1.11;+0.70) | 0.66 | −0.18 | (-1.12;+0.76) | 0.71 |
<50y, men, PIR < 125 %
d
|
(N = 1269)
|
(N = 1269)
| ||||
NHB vs. NHW | −0.05 | (-0.57;+0.46) | 0.55 | −0.07 | (-0.61;+0.47) | 0.80 |
MA vs. NHW | −0.83 | (-1.37;-0.28) | 0.003 | −0.41 | (-0.98;+0.15) | 0.15 |
≥50y, women, PIR ≥ 125 %
d
|
(N = 2420)
|
(N = 2420)
| ||||
NHB vs. NHW | −0.03 | (-0.22;+0.17) | 0.80 | +0.23 | (+0.01;+0.46) | 0.045 |
MA vs. NHW | −0.66 | (-0.95;-0.38) | <0.001 | −0.42 | (-0.83;-0.02) | 0.040 |
≥50y, men, PIR ≥ 125 %
d
|
(N = 2443)
|
(N = 2443)
| ||||
NHB vs. NHW | +0.14 | (-0.04;+0.32) | 0.13 | +0.27 | (+0.08;+0.46) | 0.005 |
MA vs. NHW | −0.15 | (-0.39;+0.08) | 0.20 | +0.04 | (-0.21;+0.29) | 0.75 |
≥50y, women, PIR < 125 %
d
|
(N = 1101)
|
(N = 1101)
| ||||
NHB vs. NHW | −0.10 | (-0.32;+0.12) | 0.38 | −0.00 | (-0.27;+0.28) | 0.99 |
MA vs. NHW | −0.61 | (-0.88;-0.34) | <0.001 | −0.25 | (-0.61;+0.10) | 0.16 |
≥50y, men, PIR < 125 %
d
|
(N = 861)
|
(N = 861)
| ||||
NHB vs. NHW | +0.09 | (-0.18;0.36) | 0.51 | +0.09 | (-0.16;+0.34) | 0.49 |
MA vs. NHW | −0.56 | (-0.87;-0.26) | <0.001 | −0.29 | (-0.60;+0.03) | 0.07 |
Model 2: Model 1+ SES factorsb | Model 3: Further adjusted for substance abuse factorsc | Model 4: Further adjusted for dietary factorsd | |||||||
---|---|---|---|---|---|---|---|---|---|
Loge(HR) | 95 % CI |
P
| Loge(HR) | 95 % CI |
P
| Loge(HR) | 95 % CI |
P
| |
<50y, women, PIR ≥ 125 %
|
(N = 3105)
|
(N = 3105)
|
(N = 3019)
| ||||||
NHB vs. NHW | −0.13 | (-0.65;+0.40) | 0.64 | −0.12 | (-0.64;+0.41) | 0.66 | −0.10 | (-0.66;+0.46) | 0.73 |
MA vs. NHW | −0.87 | (-1.69;-0.04) | 0.040 | −0.85 | (-1.64;-0.02) | 0.044 | −0.80 | (-1.64;+0.05) | 0.06 |
<50y, men, PIR ≥ 125 %
|
(N = 2860)
|
(N = 2860)
|
(N = 2773)
| ||||||
NHB vs. NHW | +0.71 | (+0.30;+1.13) | 0.001 | +0.71 | (+0.29;+1.12) | 0.001 | +0.70 | (+0.28;+1.11) | 0.001 |
MA vs. NHW | +0.06 | (-0.50;+0.62) | 0.84 | +0.04 | (-0.53;+0.60) | 0.90 | −0.06 | (-0.65;+0.53) | 0.84 |
<50y, women, PIR < 125 %
|
(N = 1728)
|
(N = 1728)
|
(N = 1683)
| ||||||
NHB vs. NHW | +0.36 | (-0.56;+1.27) | 0.44 | +0.38 | (-0.54;+1.31) | 0.40 | +0.45 | (-0.47;+1.37) | 0.32 |
MA vs. NHW | −0.59 | (-2.06;+0.87) | 0.42 | −0.40 | (-1.91;+1.10) | 0.59 | −0.43 | (-2.03;+1.17) | 0.59 |
<50y, men, PIR < 125 %
|
(N = 1269)
|
(N = 1269)
|
(N = 1232)
| ||||||
NHB vs. NHW | −0.14 | (-0.73;+0.45) | 0.64 | −0.13 | (-0.73;+0.45) | 0.65 | +0.06 | (-0.51;+0.64) | 0.84 |
MA vs. NHW | −0.75 | (-1.41;-0.08) | 0.027 | −0.75 | (-1.43;-0.07) | 0.031 | −0.44 | (-1.12;+0.25) | 0.21 |
≥50y, women, PIR ≥ 125 %
|
(N = 2420)
|
(N = 2420)
|
(N = 2345)
| ||||||
NHB vs. NHW | +0.16 | (-0.06;+0.38) | 0.17 | +0.16 | (-0.06;+0.38) | 0.15 | +0.13 | (-0.10;+0.36) | 0.28 |
MA vs. NHW | −0.54 | (-0.92;-0.15) | 0.006 | −0.54 | (-0.92;-0.15) | 0.006 | −0.44 | (-0.82;-0.07) | 0.021 |
≥50y, men, PIR ≥ 125 %
|
(N = 2443)
|
(N = 2443)
|
(N = 2339)
| ||||||
NHB vs. NHW | +0.19 | (-0.00;+0.38) | 0.05 | +0.19 | (-0.01;+0.39) | 0.06 | +0.06 | (-0.15;+0.27) | 0.58 |
MA vs. NHW | −0.08 | (-0.35;+0.18) | 0.56 | −0.08 | (-0.36;-0.19) | 0.54 | −0.07 | (-0.35;+0.21) | 0.61 |
≥50y, women, PIR < 125 %
|
(N = 1101)
|
(N = 1101)
|
(N = 1046)
| ||||||
NHB vs. NHW | −0.00 | (-0.27;+0.27) | 0.98 | +0.00 | (-0.27;+0.27) | 0.99 | −0.01 | (-0.30;+0.28) | 0.93 |
MA vs. NHW | −0.27 | (-0.68;+0.15) | 0.21 | −0.25 | (-0.67;+0.17) | 0.24 | −0.22 | (-0.66;+0.23) | 0.34 |
≥50y, men, PIR < 125 %
|
(N = 861)
|
(N = 861)
|
(N = 805)
| ||||||
NHB vs. NHW | +0.06 | (-0.21;+0.32) | 0.68 | +0.08 | (-0.18;+0.34) | 0.53 | +0.08 | (-0.21;+0.38) | 0.57 |
MA vs. NHW | −0.40 | (-0.79;-0.02) | 0.041 | −0.37 | (-0.75;+0.02) | 0.06 | −0.29 | (-0.68;+0.10) | 0.15 |
Model 5: Model 4 further adjusted for physical activityb | Model 6: Model 5 further adjusted for cigarette smokingc | Model 7: Model 6 further adjusted for social support factorsd | |||||||
---|---|---|---|---|---|---|---|---|---|
Loge(HR) | 95 % CI |
P
| Loge(HR) | 95 % CI |
P
| Loge(HR) | 95 % CI |
P
| |
<50y, women, PIR ≥ 125 %
|
(N = 3019)
|
(N = 3019)
|
(N = 3019)
| ||||||
NHB vs. NHW | −0.13 | (-0.70;+0.44) | 0.65 | −0.14 | (-0.71;+0.42) | 0.63 | −0.16 | (-0.73;+0.40) | 0.57 |
MA vs. NHW | −0.74 | (-1.57;+0.09) | 0.08 | −0.74 | (-1.57;+0.08) | 0.08 | −0.76 | (-1.59;+0.07) | 0.07 |
<50y, men, PIR ≥ 125 %
|
(N = 2773)
|
(N = 2773)
|
(N = 2773)
| ||||||
NHB vs. NHW | +0.72 | (+0.31;+1.12) | 0.001 | +0.83 | (+0.37;+1.29) | <0.001 | +0.80 | (+0.32;+1.28) | <0.001 |
MA vs. NHW | −0.05 | (-0.63;+0.54) | 0.88 | +0.11 | (-0.53;+0.75) | 0.74 | +0.11 | (-0.55;+0.78) | 0.73 |
<50y, women, PIR < 125 %
|
(N = 1683)
|
(N = 1683)
|
(N = 1683)
| ||||||
NHB vs. NHW | +0.43 | (-0.48;+1.34) | 0.34 | +0.43 | (-0.48;+1.34) | 0.35 | +0.49 | (-0.42;1.40) | 0.29 |
MA vs. NHW | −0.46 | (-2.03;+1.11) | 0.56 | −0.43 | (-1.95;+1.08) | 0.57 | −0.37 | (-1.85;1.10) | 0.61 |
<50y, men, PIR < 125 %
|
(N = 1232)
|
(N = 1232)
|
(N = 1232)
| ||||||
NHB vs. NHW | +0.08 | (-0.48;+0.64) | 0.79 | +0.13 | (-0.48;+0.74) | 0.68 | +0.18 | (-0.45;+0.80) | 0.58 |
MA vs. NHW | −0.38 | (-1.04;+0.29) | 0.26 | −0.31 | (-1.01;+0.39) | 0.39 | −0.34 | (-1.10;+0.41) | 0.37 |
≥50y, women, PIR ≥ 125 %
|
(N = 2345)
|
(N = 2345)
|
(N = 2345)
| ||||||
NHB vs. NHW | +0.10 | (-0.13;+0.33) | 0.39 | +0.21 | (-0.03;+0.44) | 0.08 | +0.22 | (-0.01;+0.45) | 0.06 |
MA vs. NHW | −0.49 | (-0.87;-0.12) | 0.010 | −0.41 | (-0.81;-0.01) | 0.042 | −0.39 | (-0.79;+0.00) | 0.05 |
≥50y, men, PIR ≥ 125 %
|
(N = 2339)
|
(N = 2339)
|
(N = 2339)
| ||||||
NHB vs. NHW | +0.09 | (-0.13;+0.31) | 0.41 | +0.16 | (-0.06;+0.38) | 0.16 | +0.17 | (-0.05;+0.39) | 0.13 |
MA vs. NHW | −0.05 | (-0.33;+0.23) | 0.75 | +0.04 | (-0.25;+0.32) | 0.79 | +0.05 | (-0.23;+0.36) | 0.70 |
≥50y, women, PIR < 125 %
|
(N = 1046)
|
(N = 1046)
|
(N = 1046)
| ||||||
NHB vs. NHW | −0.06 | (-0.35;+0.22) | 0.65 | −0.01 | (-0.30;+0.27) | 0.93 | −0.01 | (-0.29;+0.27) | 0.95 |
MA vs. NHW | −0.25 | (-0.69;+0.20) | 0.27 | −0.17 | (-0.61;+0.26) | 0.43 | −0.16 | (-0.58;+0.26) | 0.95 |
≥50y, men, PIR < 125 %
|
(N = 805)
|
(N = 805)
|
(N = 805)
| ||||||
NHB vs. NHW | +0.05 | (-0.26;+0.36) | 0.75 | +0.10 | (-0.21;+0.41) | 0.54 | +0.13 | (-0.20;0.45) | 0.44 |
MA vs. NHW | −0.32 | (-0.72;+0.09) | 0.13 | −0.24 | (-0.68;+0.19) | 0.27 | −0.25 | (-0.69;+0.20) | 0.27 |
Model 8: Model 7 further adjusted for health-related factors: Full modelb | |||
---|---|---|---|
Loge(HR) | 95 % CI |
P
| |
<50y, women, PIR ≥ 125 %
|
(N = 3019)
| ||
NHB vs. NHW | −0.46 | (-1.08;+0.15) | 0.14 |
MA vs. NHW | −1.17 | (-2.06;-0.29) | 0.009 |
<50y, men, PIR ≥ 125 %
|
(N = 2,773)
| ||
NHB vs. NHW | +0.73 | (+0.25;+1.22) | 0.003 |
MA vs. NHW | +0.05 | (-0.62;+0.72) | 0.88 |
<50y, women, PIR < 125 %
|
(N = 1,683)
| ||
NHB vs. NHW | +0.33 | (-0.63;+1.29) | 0.50 |
MA vs. NHW | −0.47 | (-1.95;+0.99) | 0.52 |
<50y, men, PIR < 125 %
|
(N = 1,232)
| ||
NHB vs. NHW | +0.15 | (-0.53;+0.84) | 0.66 |
MA vs. NHW | −0.46 | (-1.30;+0.38) | 0.29 |
≥50y, women, PIR ≥ 125 %
|
(N = 2,345)
| ||
NHB vs. NHW | +0.11 | (-0.13;+0.36) | 0.36 |
MA vs. NHW | −0.46 | (-0.85;-0.06) | 0.024 |
≥50y, men, PIR ≥ 125 %
|
(N = 2,339)
| ||
NHB vs. NHW | +0.12 | (-0.11;+0.34) | 0.30 |
MA vs. NHW | +0.03 | (-0.26;+0.32) | 0.84 |
≥50y, women, PIR < 125 %
|
(N = 1,046)
| ||
NHB vs. NHW | −0.14 | (-0.44;+0.16) | 0.35 |
MA vs. NHW | −0.18 | (-0.64;+0.27) | 0.43 |
≥50y, men, PIR < 125 %
|
(N = 805)
| ||
NHB vs. NHW | +0.05 | (-0.28;0.38) | 0.75 |
MA vs. NHW | −0.33 | (-0.81;+0.15) | 0.18 |
Race/ethnicity and all-cause mortality: individual mediators in the total adult population
Race/ethnicity and cause-specific mortality
Loge(HR) | 95 % CI |
P
| |
---|---|---|---|
Cardiovascular mortality
| |||
Age, sex, PIR-adjusted model
b
| |||
NHB vs. NHW | +0.22 | (+0.07;+0.37) | 0.005 |
MA vs. NHW | −0.21 | (-0.42;0.00) | 0.05 |
Full model
c
| |||
NHB vs. NHW | +0.09 | (-0.10;0.28) | 0.33 |
MA vs. NHW | −0.31 | (-0.58;-0.04) | 0.024 |
Neoplasms
| |||
Age, sex, PIR-adjusted model
b
| |||
NHB vs. NHW | +0.24 | (+0.05;+0.44) | 0.014 |
Mexican-American vs. NHW | −0.33 | (-0.60;-0.05) | 0.021 |
Full model
c
| |||
NHB vs. NHW | +0.35 | (+0.01;+0.68) | 0.044 |
MA vs. NHW | +0.21 | (-0.23;0.64) | 0.35 |