ArticleSSM - population health2022
Mortality disparities between Black and White Americans mediated by income and health behaviors.
Article in SSM - population health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Equity and Cancer Survival Among Veterans Health Administration Patients: A Systematic Review and Meta-Analysis.JAMA network open · 2026Pooled it
- Early Home Visits and Health Outcomes in Low-Income Mothers and Offspring: 18-Year Follow-Up of a Randomized Clinical Trial.JAMA network open · 2024Trial
- Unequal embodiment: racial and ethnic heterogeneity in the predictors and age-related health outcomes associated with accelerated biological aging.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Article
- Investigating demographic and geographic disparities in malnutrition and gastrointestinal cancer mortality among older adults in the United States: A comprehensive longitudinal Centers for Disease Control and Prevention WONDER analysis 1999-2020.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2026Article
- Attending an Historically Black College or University and all-cause mortality in US Black adults.American journal of epidemiology · 2026Article
- Multiethnic community cardio-metabolic risk factor screening in Northeast Florida: The VIDASANA Project.American heart journal plus : cardiology research and practice · 2026Article
- A Multi-Modal Transfer Learning Framework to Reduce Health Disparities in Prostate Adenocarcinoma.bioRxiv : the preprint server for biology · 2025Article
- Cumulative social determinants of health and frailty risk in older adults.BMC geriatrics · 2025Article
- Telomere Length, Epigenetic Age Acceleration, and Mortality Risk in US Adult Populations: An Additive Bayesian Network Analysis.Aging cell · 2025Article
- Spatially Continuous Maps of Disease Risk: An Analysis of Mortality Disparities in the United States.AJPM focus · 2025Article
- Inequity in US Racial/Ethnic Infant Health and Birth Outcomes: The Role of the Adult Sex Ratio as a Potential Indicator of Structural Anti-Black Racism.Journal of racial and ethnic health disparities · 2025Article
- Association between social determinants of health and premature atherosclerotic cardiovascular disease and sex differences in US adults: A cross-sectional study.Preventive medicine reports · 2025Article
- Individual-Level Exposure to Residential Redlining in 1940 and Mortality Risk.JAMA internal medicine · 2024Article
- Health and Community Care Workers' Knowledge and Perceptions of Social Prescribing in Singapore.Annals of geriatric medicine and research · 2024Article
- Association between social determinants of health and survival among the US cancer survivors population.BMC medicine · 2024Article
- Ultraviolet Radiation Biological and Medical Implications.Current issues in molecular biology · 2024Review
- Compliance with the 24-hour movement guidelines and weight status: results from 40,970 adolescents.Frontiers in public health · 2024Article
- Social determinants of health and premature death among adults in the USA from 1999 to 2018: a national cohort study.The Lancet. Public health · 2023Article
- A qualitative study of ecological and motivational factors to inform weight management interventions for Black men in the rural South of the United States.Social science & medicine (1982) · 2023Article
- Impacts of a Workplace-Based Weight-Control Intervention on Objective and Perceived Physical Activity among a Subgroup of Workers.Journal of healthy eating and active living · 2022Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRace disparities in health outcomes including mortality risk are well known, but mediating mechanisms that link race to mortality risk have rarely been formally tested.
methodsWe analyzed public NHANES III data from 1988 to 1994 linked to mortality outcomes prospectively through 2015. Participants included 10,460 non-Hispanic Black (40.5%, n = 4233) and non-Hispanic White (59.5%, n = 6227) adults. Proportional hazards regression models examined mortality risk in association with race, demographics, income, and an index of risky health behaviors including smoking, poor diet and low physical activity. A mediation approach under the counterfactual framework was used to test effects of income and risky health behaviors as mediators between race and mortality risk.
resultsConsidering only race, age and sex, Black participants had significantly higher mortality risk than Whites (HR = 1.46, 95% CI 1.35-1.58). When income and education were added, the race effect was lower but remained significant (HR = 1.15, 95% CI 1.02-1.30). In the subsequent model that also included risky behaviors the association between race and mortality was no longer significant (HR = 1.05, 95% CI 0.92-1.20); both higher income and healthier behaviors contributed to lower mortality risk. There was a significant indirect effect of race on mortality mediated through income, and the direct effect of race on mortality was not significant when the mediating effect of income was considered. Likewise, the risky behavior score significantly mediated the association between race with mortality, and the direct effect of race was not significant. In the separate models, income mediated 62% of the association between race and mortality and lifestyle mediated 61% of the relationship.
conclusionsEfforts to reduce race-based mortality disparities may focus on policies to reduce income-based disparities and promote positive health behaviors that consider variations in socioeconomic resources and personal preferences.
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