Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2006

Open Access 01-12-2006 | Research

Demographic and biologic influences on survival in whites and blacks: 40 years of follow-up in the Charleston heart study

Published in: International Journal for Equity in Health | Issue 1/2006

Login to get access

Abstract

Background

In the United States, life expectancy is significantly lower among blacks than whites. We examined whether socioeconomic status (SES) and cardiovascular disease (CVD) risk factors may help explain this disparity.

Methods

Forty years (1961 through 2000) of all-cause mortality data were obtained on a population-based cohort of 2,283 subjects in the Charleston Heart Study (CHS). We examined the influence of SES and CVD risk factors on all-cause mortality.

Results

Complete data were available on 98% of the original sample (647 white men, 728 white women, 423 black men, and 443 black women). After adjusting for SES and CVD risk factors, the hazard ratios (HRs) for white ethnicity were 1.14 (0.98 to 1.32) among men and 0.90 (0.75 to 1.08) among women, indicating that the mortality risk was 14% greater for white men and 10% lower for white women compared to their black counterparts. However the differences were not statistically significant.

Conclusion

While there are marked contrasts in mortality among blacks and whites in the CHS, the differences can be largely explained by SES and CVD risk factors. Continued focus on improving and controlling cardiovascular disease risk factors may reduce ethnic disparities in survival.
Appendix
Available only for authorised users
Literature
1.
2.
Institute of Medicine: Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. 2002, Washington, DC: National Academy Press
3.
Williams JE, Massing M, Rosamond WD, Sorlie PD, Tyroler HA: Racial disparities in CHD mortality from 1968-1992 in the state economic areas surrounding the ARIC study communities. Atherosclerosis Risk in Communities. Ann Epidemiol. 1999, 9: 472-480. 10.1016/S1047-2797(99)00029-0.CrossRefPubMed
4.
Armstrong DL, Strogatz D, Wang R: United States coronary mortality trends and community services associated with occupational structure, among blacks and whites, 1984-1998. Soc Sci Med. 2004, 58: 2349-2361. 10.1016/j.socscimed.2003.08.030.CrossRefPubMed
5.
Williams DR: Race, socioeconomic status, and health. The added effects of racism and discrimination. Ann N Y Acad Sci. 1999, 896: 173-188. 10.1111/j.1749-6632.1999.tb08114.x.CrossRefPubMed
6.
Whittle J, Conigliaro J, Good CB, Lofgren RP: Racial differences in the use of invasive cardiovascular procedures in the Department of Veterans Affairs medical system. New Engl J Med. 1993, 329: 621-627. 10.1056/NEJM199308263290907.CrossRefPubMed
7.
McBean AM, Gornick M: Differences by race in the rates of procedures performed in hospitals for Medicare beneficiaries. Health Care Financing Review. 1994, 15: 77-90.PubMedPubMedCentral
8.
Kaplan GA, Keil JE: Socioeconomic factors and cardiovascular disease: a review of the literature. Circulation. 1993, 88: 1973-1998.CrossRefPubMed
9.
Feinstein JS: The relationship between socioeconomic status and health: a review of the literature. Milbank Q. 1993, 71: 279-322.CrossRefPubMed
10.
Keil JE, Sutherland SE, Knapp RG, Tyroler HA: Does equal socioeconomic status in black and white men mean equal risk of mortality?. Am J Public Health. 1992, 82: 1133-1136.CrossRefPubMedPubMedCentral
11.
Hames CG, Rose K, Knowles M, Davis CE, Tyroler HA: Black-white comparisons of 20-year coronary heart disease mortality in the Evans County Heart Study. Cardiology. 1993, 82: 122-136.CrossRefPubMed
12.
Howard G, Anderson RT, Russell G, Howard VJ, Burke GL: Race, socioeconomic status, and cause-specific mortality. Ann Epidemiol. 2000, 10: 214-223. 10.1016/S1047-2797(00)00038-7.CrossRefPubMed
13.
Koskinen S, Martelin T: Why are socioeconomic mortality differences smaller among women than among men?. Soc Sci Med. 1994, 38: 1385-1396. 10.1016/0277-9536(94)90276-3.CrossRefPubMed
14.
Mustard CA, Etches J: Gender differences in socioeconomic inequality in mortality. Journal of Epidemiology and Community Health. 2003, 57: 974-980. 10.1136/jech.57.12.974.CrossRefPubMedPubMedCentral
15.
Thurston RC, Kubzansky LD, Kawachi I, Berkman LF: Is the association between socioeconomic position and coronary heart disease stronger in women than in men?. Am J Epi. 2005, 162: 57-65. 10.1093/aje/kwi159.CrossRef
16.
Keil JE, Sutherland SE, Knapp RG, Lackland DT, Gazes PC, Tyroler HA: Mortality rates and risk factors for coronary disease in black as compared with white men and women. New Engl J Med. 1993, 329: 73-78. 10.1056/NEJM199307083290201.CrossRefPubMed
17.
Boyle E: Biological patterns in hypertension by race, sex, body weight, and skin color. JAMA. 1970, 213: 1637-1643. 10.1001/jama.213.10.1637.CrossRefPubMed
18.
19.
20.
Keil JE, Sutherland SE, Hames CG, Lackland DT, Gazes PC, Knapp RG, Tyroler HA: Coronary disease mortality and risk factors in black and white men. Results from the combined Charleston, SC, and Evans County, Georgia, heart studies. Arch Intern Med. 1995, 155: 1521-1527. 10.1001/archinte.155.14.1521.CrossRefPubMed
21.
Ding J, Diez Roux AV, Nieto FJ, McNamara RL, Hetmanski JB, Taylor HA, Tyroler HA: Racial disparity in long-term mortality rate after hospitalization for myocardial infarction: the Atherosclerosis Risk in Communities study. Am Heart J. 2003, 146: 459-464. 10.1016/S0002-8703(03)00228-X.CrossRefPubMed
22.
Godley PA, Schenck AP, Amamoo MA, Schoenbach VJ, Peacock S, Manning M, Symons M, Talcott JA: Racial differences in mortality among Medicare recipients after treatment for localized prostate cancer. J Natl Cancer Inst. 2003, 95: 1702-1710.CrossRefPubMed
23.
24.
Barnett E, Casper ML, Halverson JA, Elmes GA, Braham VE, Majeed ZA, Bloom AS, Stanley S: Men and Heart Disease: An Atlas of Racial and Ethnic Disparities in Mortality. 2001, Morgantown, WV: Office for Social Environment and Health Research, West Virginia University, 1
25.
Casper ML, Barnett E, Halverson JA, Elmes GA, Braham VE, Majeed ZA, Bloom AS, Stanley S: Women and Heart Disease: An Atlas of Racial and Ethnic Disparities in Mortality. 2000, Morgantown, WV: Office for Social Environment and Health Research, West Virginia University, 2
26.
Ayala C, Greenlund KJ, Croft JB, Keenan NL, Donehoo RS, Giles WH, Kittner SJ, Marks JS: Racial/ethnic disparities in mortality by stroke subtype in the United States, 1995-1998. Am J Epidemiol. 2001, 154: 1057-1063. 10.1093/aje/154.11.1057.CrossRefPubMed
27.
National Academy on Aging. One in four: child poverty in America. The Public Policy and Aging Report 8. 1997.
28.
Bindman AB, Grumbach K, Osmond D, Komaromy M, Vranizan K, Lurie N, Billings J, Stewart A: Preventable hospitalizations and access to health care. JAMA. 1995, 274: 305-311. 10.1001/jama.274.4.305.CrossRefPubMed
29.
Lantz PM, House JS, Lepkowski JM, Williams DR, Mero RP, Chen J: Socioeconomic factors, health behaviors, and mortality: results from a nationally representative prospective study of US adults. JAMA. 1998, 279: 1703-1708. 10.1001/jama.279.21.1703.CrossRefPubMed
30.
Lantz PM, Lynch JW, House JS, Lepkowski JM, Mero RP, Musick MA, Williams DR: Socioeconomic disparities in health change in a longitudinal study of US adults: the role of health-risk behaviors. Soc Sci Med. 2001, 53: 29-40. 10.1016/S0277-9536(00)00319-1.CrossRefPubMed
31.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, Materson BJ, Oparil S, Wright JT: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003, 289: 2560-2572. 10.1001/jama.289.19.2560.CrossRefPubMed
32.
Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002, 106: 3143-3421.
33.
Metadata
Title
Demographic and biologic influences on survival in whites and blacks: 40 years of follow-up in the Charleston heart study
Publication date
01-12-2006
Published in
International Journal for Equity in Health / Issue 1/2006
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/1475-9276-5-8

Other articles of this Issue 1/2006

International Journal for Equity in Health 1/2006 Go to the issue

Commentary

What potential has tobacco control for reducing health inequalities? The New Zealand situation

Research

In the absence of cancer registry data, is it sensible to assess incidence using hospital separation records?

Research

Variation in prescribing for anxiety and depression: a reflection of health inequalities, cultural differences or variations in access to care?

Research

Incorporating concepts of inequality and inequity into health benefits analysis

Research

Rural-urban differentials of premature mortality burden in south-west China

Research

Mastery, perceived stress and health-related behaviour in northeast Arnhem Land: a cross-sectional study