The contribution of behavioural and metabolic risk factors to socioeconomic inequalities in mortality: the Italian Longitudinal Study

Int J Public Health. 2018 Apr;63(3):325-335. doi: 10.1007/s00038-018-1076-8. Epub 2018 Jan 30.

Abstract

Objectives: The aim of this study was to assess social inequalities in overall mortality in a representative sample of the Italian population, and to evaluate the contribution of behavioural and metabolic risk (BMF) factors to these inequalities.

Methods: 85,308 participants aged 25-74 years from the Italian Longitudinal Study were included in the study population and followed up for mortality (1999-2012). Level of education was used as a proxy for socioeconomic status. The contribution of BMF was estimated assessing the attenuation of the risk by education produced by the inclusion of BMF in regression model.

Results: Men with the lowest education had 62% and women had 57% greater risk of dying than those with the highest education. Among men, adjustment for BMF produced an attenuation of the mortality risk between extreme classes of education by 22%, while among women the risk attenuation was 7%.

Conclusions: Large educational differences in mortality were observed for both men and women. BMF reduced by approximately 20% differences in mortality relative risk between extreme classes of education in men. In contrast, a very low contribution was observed in women.

Keywords: Behavioural risk factors; Lifestyle; Metabolic risk factors; Mortality; Socioeconomic inequalities.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Cause of Death
  • Educational Status*
  • Female
  • Health Behavior*
  • Health Status Disparities*
  • Humans
  • Italy / epidemiology
  • Language
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Mortality*
  • Risk Factors
  • Sex Factors
  • Socioeconomic Factors