Impact of education, income and chronic disease risk factors on mortality of adults: Does 'a pauper-rich paradox' exist in Latin American societies?

Public Health

Volumn 124, Issue 1, 2010, Pages 39-48

  Koch, E ^a   Romero, T ^b   Romero, C X ^c   Akel, C ^a   Manriquez L ^d   Paredes, M ^e   Roman C ^e   Taylor, A ^e   Vargas, M ^e   Kirschbaum, A ^a  

^a UNIVERSITY OF CHILE   (Chile)

^b Sharp Health System   (United States)

^c UNIVERSITY OF COLORADO   (United States)

^d Regional Hospital   (Chile)

^e San Francisco de Mostazal   (Chile)

Author keywords

Cardiovascular risk factors; Developing country; Education; Health inequalities; Income

Indexed keywords

HIGH DENSITY LIPOPROTEIN CHOLESTEROL; LOW DENSITY LIPOPROTEIN CHOLESTEROL;

CARDIOVASCULAR DISEASE; DEVELOPING WORLD; DISEASE PREVALENCE; EDUCATIONAL ATTAINMENT; HYPOTHESIS TESTING; INCOME; MORTALITY RISK; REGRESSION ANALYSIS; RISK FACTOR; SOCIOECONOMIC CONDITIONS;

ADULT; ALCOHOL CONSUMPTION; ARTICLE; CARDIOVASCULAR DISEASE; CHILE; CHOLESTEROL BLOOD LEVEL; CHRONIC DISEASE; CONTROLLED STUDY; DIABETES MELLITUS; EDUCATIONAL STATUS; FAMILY HISTORY; FEMALE; FOLLOW UP; GLUCOSE BLOOD LEVEL; HEALTH DISPARITY; HUMAN; HYPERTENSION; INCOME; MALE; MORTALITY; OBESITY; RANDOM SAMPLE; RISK FACTOR; SMOKING; SOCIOECONOMICS; SOUTH AND CENTRAL AMERICA; SURVIVAL RATE; TRIACYLGLYCEROL BLOOD LEVEL;

ADULT; AGE DISTRIBUTION; AGED; AGED, 80 AND OVER; CAUSE OF DEATH; CHILE; CHRONIC DISEASE; COHORT STUDIES; EDUCATIONAL STATUS; FEMALE; FOLLOW-UP STUDIES; HUMANS; INCOME; MALE; MIDDLE AGED; MORTALITY; PREVALENCE; PROPORTIONAL HAZARDS MODELS; PROSPECTIVE STUDIES; RISK ASSESSMENT; RISK FACTORS; SEX DISTRIBUTION;

CHILE; LATIN AMERICA;

EID: 76449115031     PISSN: 00333506     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.puhe.2009.11.008     Document Type: Article

References (49)

1. Galobardes B., Lynch J., Smith G.D. Measuring socioeconomic position in health research. Br Med Bull 2007, 81-82:21-37.
2. Silventoinen K., Pankow J., Jousilahti P., Hu G., Tuomilehto J. Educational inequalities in the metabolic syndrome and coronary heart disease among middle-aged men and women. Int J Epidemiol 2005, 34:327-334.
3. Davey Smith G., Hart C., Hole D., MacKinnon P., Gillis C., Watt G., et al. Education and occupational social class: which is the more important indicator of mortality risk?. J Epidemiol Community Health 1998, 52:153-160.
4. Lynch J.W., Kaplan G.A., Cohen R.D., Tuomilehto J., Salonen J.T. Do cardiovascular risk factors explain the relation between socioeconomic status, risk of all-cause mortality, cardiovascular mortality, and acute myocardial infarction?. Am J Epidemiol 1996, 144:934-942.
5. Bopp M., Minder C. Mortality by education in German speaking Switzerland, 1990-1997: results from the Swiss National Cohort. Int J Epidemiol 2003, 32:346-354.
6. Steenland K., Henley J., Thun M. All-cause and cause-specific death rates by educational status for two million people in two American Cancer Society cohorts, 1959-1996. Am J Epidemiol 2002, 156:11-21.
7. Osler M., Prescott E., Gronback M., Christensen U., Due P., Engholm G. Income inequality, individual income, and mortality in Danish adults: analysis of pooled data from two cohort studies. BMJ 2002, 324:13-16.
8. Qureshl A.I., Suri M.F., Saad M., Hopkins L.N. Educational attainment and risk of stroke and myocardial infarction. Med Sci Monit 2003, 9:CR466-CR473.
9. Khang Y.H., Kim H.R. Explaining socioeconomic inequality in mortality among South Koreans: an examination of multiple pathways in a nationally representative longitudinal study. Int J Epidemiol 2005, 34:630-637.
10. Hirokawa K., Tsutusmi A., Kayaba K. Impacts of educational level and employment status on mortality for Japanese women and men: the Jichi Medical School cohort study. Eur J Epidemiol 2006, 21:641-651.
11. Gwatkin D.R. Health inequalities and the health of the poor: what do we know? What can we do?. Bull World Health Organ 2000, 78:3-18.
12. Kawachi I., Subramanian S.V., Almeida-Filho N. A glossary for health inequalities. J Epidemiol Community Health 2002, 56:647-652.
13. Braveman P., Gruskin S. Defining equity in health. J Epidemiol Community Health 2003, 57:254-258.
14. Link B.G., Phelan J.C. Fundamental sources of health inequalities. Policy challenges in modern health care 2005, Rutgers University Press, New Brunswick. D. Mechanic, L. Rogut, D. Colby, J. Knickman (Eds.).
15. Willcox B.J., He Q., Chen R., Yano K., Masaki K.H., Grove J.S., et al. Midlife risk factors and healthy survival in men. JAMA 2006, 296:2343-2350.
16. Albert M.A., Glynn R.J., Buring J., Ridker P.M. Impact of traditional and novel risk factors on the relationship between socioeconomic status and incident cardiovascular events. Circulation 2006, 114:2619-2626.
17. Szot Meza J. Demographic-epidemiologic transition in Chile, 1960-2001. Rev Esp Salud Publica 2003, 77:605-613.
18. Subramanian S., Delgado I., Jadue L., Vega J., Kawachi I. Income inequality and health: multilevel analysis of Chilean communities. J Epidemiol Community Health 2003, 57:844-848.
19. Koch E., Bogado M., Araya F., Romero T., Diaz C., Manriquez L., et al. Impact of parity on anthropometric measures of obesity controlling by multiple confounders. A cross-sectional study in Chilean women. J Epidemiol Community Health 2008, 62:461-470.
20. United Nations Development Programme. Human development report 2005. New York. Available at: ; (last accessed 3.12.2009). http://www.undp.org.tr/undp/docs/HDR2005.pdf.
21. Koch E., Romero T., Manríquez L., Paredes M., Ortúzar E., Taylor A., et al. Socioeconomic and educational inequities as independent predictors for mortality in a developing country: a cohort study in San Francisco, Chile. Rev Med Chil 2007, 135:1370-1379.
22. Koch E., Otarola A., Manríquez L., Kirschbaum A., Paredes M., Silva C. Predictors of non fatal cardiovascular events in a Chilean cohort: results of the San Francisco Project. Rev Med Chile 2005, 133:1002-1012.
23. Government of Chile Ministry of Health. First national health survey. Final report 2004, Ministry of Health, Santiago, Chile, Available from:, (last accessed 15.08.2008). http://epi.minsal.cl/epi/html/invest/ENS/InformeFinalENS.pdf.
24. Koch E., Silva C., Manriquez L., Ahumada C. The San Francisco Project I: high prevalence of cardiovascular risk factors in adults over 15 years of age. Rev Chil Cardiol 2000, 19:27-42.
25. Chobanian A.V., Bakris G.L., Black H.R., et al. 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.
26. Expert Panel on Detection Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the 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). JAMA 2001, 285:2486-2497.
27. Expert Committee on the Diagnosis and Classification of Diabetes Mellitus Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 1997, 20:1183-1197.
28. Orpinas P., Valdés M., Pemjean A., Florenzano R. Validación de una escala breve para la detección de beber anormal (E.B.B.A. Temas de Salud Mental y Atención Primaria de Salud 1991, 185-193. Facultad de Medicina, Universidad de Chile, Santiago. R. Florenzano, N. Horwitz, M. Penna, M. Valdés (Eds.).
29. Núñez F.M.L., Icaza N.M.G. Quality of mortality statistics in Chile, 1997-2003. Rev Med Chil 2006, 134:1191-1196.
30. Lantz P.M., Lynch J.W., House J.S., Lepkowski J.M., Mero R.P., Musick M.A., et al. 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.
31. Bucher H., Ragland D.R. Socioeconomic indicators and mortality from coronary heart disease and cancer: a 22-year follow-up of middle-aged men. Am J Public Health 1995, 85:1231-1236.
32. Davey Smith G., Neaton J.D., Wentworth D., Stamler R., Stamler J. Mortality differences between black and white men in the USA: contribution of income and other risk factors among men screened for the MRFIT. MRFIT Research Group. Multiple Risk Factor Intervention Trial. Lancet 1998, 351:934-939.
33. Lantz P.M., House J.S., Lepkowski J.M., Williams D.R., Mero R.P., Chen J. Socioeconomic factors, health behaviors, and mortality: results from a nationally representative prospective study of US adults. JAMA 1998, 279:1703-1708.
34. Backlund E., Sorlie P., Johnson N. A comparison of the relationships of education and income with mortality: the national longitudinal mortality study. Soc Sci Med 1999, 49:1373-1384.
35. Sundquist J., Johansson S.E. Indicators of socioeconomic position and their relation to mortality in Sweden. Soc Sci Med 1997, 45:1757-1766.
36. Hardarson T., Gardarsdóttir M., Gudmundsson K.T., Thorgeirsson G., Sigvaldason H., Sigfússon N. The relationship between educational level and mortality. The Reykjavík Study. J Intern Med 2001, 249:495-502.
37. Manor O., Eisenbach Z., Israeli A., Friedlander Y. Mortality differentials among women: the Israel Longitudinal Mortality Study. Soc Sci Med 2000, 51:1175-1188.
38. Kaplan G.A. What's wrong with social epidemiology, and how can we make it better?. Epidemiol Rev 2004, 26:124-135.
39. Bernheim S.M., Spertus J.A., Reid K.J., Bradley E.H., Desai R.A., Peterson E.D., et al. Socioeconomic disparities in outcomes after acute myocardial infarction. Am Heart J 2007, 153:313-319.
40. Ranjit N., Diez-Roux A.V., Shea S., Cushman M., Seeman T., Jackson S.A., et al. Psychosocial factors and inflammation in the multi-ethnic study of atherosclerosis. Arch Intern Med 2007, 167:174-181.
41. Ranjit N., Diez-Roux A.V., Shea S., Cushman M., Ni H., Seeman T. Socioeconomic position, race/ethnicity, and inflammation in the multi-ethnic study of atherosclerosis. Circulation 2007, 116:2383-2390.
42. Loucks E.B., Sullivan L.M., Hayes L.J., D'Agostino R.B., Larson M.G., Vasan R.S., et al. Association of educational level with inflammatory markers in the Framingham Offspring Study. Am J Epidemiol 2006, 163:622-628.
43. Rosmond R., Wallerius S., Wanger P., Martin L., Holm G., Björntorp P.A. 5-year follow-up study of disease incidence in men with an abnormal hormone pattern. J Intern Med 2003, 254:386-390.
44. Nijm J., Kristenson M., Olsson A.G., Jonasson L. Impaired cortisol response to acute stressors in patients with coronary disease. Implications for inflammatory activity. J Intern Med 2007, 262:375-384.
45. Wilkinson R.G., Pickett K.E. The problems of relative deprivation: why some societies do better than others. Soc Sci Med 2007, 65:1965-1978.
46. Lynch J., Smith G.D., Hillemeier M., Shaw M., Raghunathan T., Kaplan G. Income inequality, the psychosocial environment, and health: comparisons of wealthy nations. Lancet 2001, 358:194-200.
47. Galobardes B., Lynch J.W., Smith G.D. Is the association between childhood socioeconomic circumstances and cause-specific mortality established? Update of a systematic review. J Epidemiol Community Health 2008, 62:387-390.
48. Gelman A. Struggles with survey weighting and regression modeling. Stat Sci 2007, 22:153-164.
49. Koch E., Otarola A., Kirschbaum A. A landmark for popperian epidemiology: refutation of the randomised Aldactone evaluation study. J Epidemiol Community Health 2005, 59:1000-1006.