ArticleInternational journal of epidemiology2020
Reducing socio-economic inequalities in all-cause mortality: a counterfactual mediation approach.
Article in International journal of epidemiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 31 papers, 4 of them syntheses that pooled it.
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Who cites it
31 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Socioeconomic Inequalities and Molecular Risk for Aging in Young Adulthood.American journal of epidemiology · 2023Pooled it
- The influence of socioeconomic status on the association between unhealthy lifestyle factors and adverse health outcomes: a systematic review.Wellcome open research · 2023Pooled it
- The Role of Epigenetic Clocks in Explaining Educational Inequalities in Mortality: A Multicohort Study and Meta-analysis.The journals of gerontology. Series A, Biological sciences and medical sciences · 2022Pooled it
- Parental education and inequalities in child mortality: a global systematic review and meta-analysis.Lancet (London, England) · 2021Pooled it
- Tooth Loss and Socioeconomic Inequalities in Disability and Mortality: A Large-scale Prospective Cohort Study in Japan.Journal of epidemiology · 2026Article
- Observational
- Does lifestyle explain the relationship between socioeconomic position and multimorbidity of cancer and cardiometabolic diseases? A mediation analysis applied to the European Prospective Investigation into Cancer and Nutrition.Journal of epidemiology and community health · 2025Article
- Educational level, clinical outcomes and quality of care in a Swiss cohort of patients with acute coronary syndromes.European journal of clinical investigation · 2025Article
- Article
- Metal Mixtures Mediate the Socioeconomic Gradient in Blood Pressure: A Four-Way Decomposition in a Prospective Rural Bangladeshi Cohort.medRxiv : the preprint server for health sciences · 2025Article
- US state death rates: Structural equation modeling of Big Five personality, socioeconomic status, and health risk factors.Journal of health psychology · 2025Article
- Embodying disadvantage: a theoretically-informed analysis of pathways linking socioeconomic position with all-cause and cancer mortality in a nationally representative cohort of adults in Canada.BMC public health · 2025Article
- Educational attainment as a potential effect modifier of alcohol use and 100% alcohol-attributable mortality in the United States-A longitudinal analysis of mortality linked survey data from 1997 to 2018.Addiction (Abingdon, England) · 2025Article
- Utilize administrative data to assess impact of individual-level and neighborhood-level socioeconomic status on childhood health in a longitudinal study.Public health · 2025Observational
- Exploring Public, Practitioner and Policymaker Perspectives of Unhealthy Lifestyle Factors in the Context of Socioeconomic Deprivation: A Qualitative Study.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- The Role of Climatic, Environmental and Socioeconomic Factors in the Natural Movement of Urban Populations in Kazakhstan, 2012-2020: An Analysis from a Middle-Income Country in Central Asia.International journal of environmental research and public health · 2024Article
- Maternal Education and Children Home Alone in 63 Low- and Middle-Income Countries.Global pediatric health · 2024Article
- Educational inequalities in mortality and their mediators among generations across four decades: nationwide, population based, prospective cohort study based on the ChinaHEART project.BMJ (Clinical research ed.) · 2023Article
- Health Literacy among Older Adults in Portugal and Associated Sociodemographic, Health and Healthcare-Related Factors.International journal of environmental research and public health · 2023Article
- The Impact of Multimorbidity on All-Cause Mortality: A Longitudinal Study of 87,151 Thai Adults.International journal of public health · 2023Article
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
22 authors.
Funding
Abstract
backgroundSocio-economic inequalities in mortality are well established, yet the contribution of intermediate risk factors that may underlie these relationships remains unclear. We evaluated the role of multiple modifiable intermediate risk factors underlying socio-economic-associated mortality and quantified the potential impact of reducing early all-cause mortality by hypothetically altering socio-economic risk factors.
methodsData were from seven cohort studies participating in the LIFEPATH Consortium (total n = 179 090). Using both socio-economic position (SEP) (based on occupation) and education, we estimated the natural direct effect on all-cause mortality and the natural indirect effect via the joint mediating role of smoking, alcohol intake, dietary patterns, physical activity, body mass index, hypertension, diabetes and coronary artery disease. Hazard ratios (HRs) were estimated, using counterfactual natural effect models under different hypothetical actions of either lower or higher SEP or education.
resultsLower SEP and education were associated with an increase in all-cause mortality within an average follow-up time of 17.5 years. Mortality was reduced via modelled hypothetical actions of increasing SEP or education. Through higher education, the HR was 0.85 [95% confidence interval (CI) 0.84, 0.86] for women and 0.71 (95% CI 0.70, 0.74) for men, compared with lower education. In addition, 34% and 38% of the effect was jointly mediated for women and men, respectively. The benefits from altering SEP were slightly more modest.
conclusionsThese observational findings support policies to reduce mortality both through improving socio-economic circumstances and increasing education, and by altering intermediaries, such as lifestyle behaviours and morbidities.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.