Demographic, Socioeconomic, and Health Behavior Variables as Potential Mediators between Allostatic Load and Mortality

• In Event: 322 - Section on Medical Sociology Roundtable Session
  In Refereed Roundtable: Table 03. Neighborhood/ Community Context

Abstract

To determine whether these health behaviors mediate the known allostatic load (AL)-mortality risk relationship in models fully interacted by gender, we examined data on 16,646 men and women who participated in the third National Health and Nutrition Examination Survey (NHANES III) (1988-1994). We estimated weighted Cox regression models. Men had higher summary AL than women (p < .001), and higher metabolic and cardiovascular risk (both p < .001); women had higher inflammatory risk (p < .001). Men were twice as likely to have ever smoked than women (66% vs. 38%). AL had a strong, positive association with earlier death for men and women (both p < .001). This effect remained strong regardless of predictors entered. Lifetime tobacco use was the sole health behavior associated with earlier mortality for both men and women (both p < .001), and was stronger for women (HR = 1.83) than men (HR = 1.57), despite their lower prevalence of lifetime smoking.
Conclusions: AL continues is a strong pathway in mortality research in that its effect appears independent of numerous demographic, socioeconomic, and correlated health variables. Lifetime tobacco use is a strong predictor of earlier mortality. Further research is needed on how tobacco use is influenced by neighborhood structure for men and women, including investigation into tobacco advertisement and availability, and associations with stress and AL. Cardiovascular risk may be an important focus of research building from these findings.

Authors

• Chloe E. Bird, RAND Corporation

• Lisa M. Yarnell, University of Texas-Austin