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Socioeconomic differentials in mortality risk among men screened for the Multiple Risk Factor Intervention Trial: I. White men.

G D Smith, J D Neaton, D Wentworth, R Stamler and J Stamler

Department of Social Medicine, University of Bristol, Bristol, England.

OBJECTIVES: This study examined socioeconomic differentials in risk of death from a number of specific causes in a large cohort of White men in the United States. METHODS: For 300 685 White men screened for the Multiple Risk Factor Intervention Trial between 1973 and 1975, data were collected on median income of White households in the zip code of residence, age, cigarette smoking, blood pressure, serum cholesterol, previous myocardial infarction, and drug treatment for diabetes. The 31 737 deaths that occurred over the 16-year follow-up period were grouped into specific causes and related to median White family income. RESULTS: There was an inverse association between age- adjusted all-cause mortality and median family income. There was no attenuation of this association over the follow-up period, and the association was similar for the 22 clinical centers carrying out the screening. The gradient was seen for many-but not all-of the specific causes of death. Other risk factors accounted for some of the association between income and coronary heart disease and smoking-related cancers. CONCLUSIONS: Socioeconomic position, as measured by median family income of area of residence, is an important determinant of mortality risk in White men.

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