All-Cause and Cause-Specific Mortality by Socioeconomic Status Among Employed Persons in 27 US States, 19841997
Kyle Steenland, PhD,
Sherry Hu, MS and
James Walker, PhD
Kyle Steenland is with the Department of Environmental and Occupational Health, Emory School of Public Health, Emory University, Atlanta, Ga. Sherry Hu is with the National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention (CDC), Atlanta. James Walker is with the National Institute for Occupational Safety and Health, CDC, Cincinnati, Ohio.
Correspondence: Requests for reprints should be sent to Kyle Steenland, PhD, Professor, Dept of Environmental and Occupational Health, Rollins School of Public Health, 1518 Clifton Ave, Atlanta, GA 30322 (e-mail: nsteenl{at}sph.emory.edu).
Objectives. We investigated mortality differences accordingto socioeconomic status (SES) for employed persons in 27 statesduring 19841997.
Methods. SES was determined for persons aged 3564 yearsaccording to the "usual occupation" listed on their death certificates.We used US Census denominator data.
Results. For all-cause mortality, rate ratios from lowest tohighest SES quartile for men and women were 2.02, 1.69, 1.25,and 1.00 and 1.29, 1.01, 1.07, and 1.00, respectively. Percentageof all deaths attributable to being in the lowest 3 SES quartileswas 27%. Inverse SES gradients were strong for most major causesof death except breast cancer and colorectal cancer. Heart diseasemortality for highest and lowest SES quartiles dropped 45% and25%, respectively, between 1984 and 1997.
Conclusions. Mortality differences by SES were sustained throughthe 1990s and are increasing for men.
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