Evidence map›Paper›PMID 40660323›Full record

ArticleArchives of public health = Archives belges de sante publique2025

The independent and joint role of socioeconomic status and family relationships on mortality risk in China: cultural differences and health inequalities in the context of intergenerational cohabitation.

Zhixi Zhu, Yiying Wang, Xin Wang, Fuyan Zhang, Lisha Yu, Tao Liu

Abstract read
In one paragraph

Article in Archives of public health = Archives belges de sante publique, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Zhixi ZhuSchool of Economics and Management, University of Hong Kong, Hong Kong, 999077, China.
Yiying WangGuizhou Provincial Center for Disease Control and Prevention, Chronic Disease Prevention and Cure Research Institute, Guiyang, Guizhou, 555004, China.
Xin WangGuizhou Provincial Center for Disease Control and Prevention, Chronic Disease Prevention and Cure Research Institute, Guiyang, Guizhou, 555004, China.
Fuyan ZhangGuizhou Provincial Center for Disease Control and Prevention, Chronic Disease Prevention and Cure Research Institute, Guiyang, Guizhou, 555004, China.
Lisha YuGuizhou Provincial Center for Disease Control and Prevention, Chronic Disease Prevention and Cure Research Institute, Guiyang, Guizhou, 555004, China. JIxiaobei621@163.com.
Tao LiuGuizhou Provincial Center for Disease Control and Prevention, Chronic Disease Prevention and Cure Research Institute, Guiyang, Guizhou, 555004, China. liutao9099@163.com.

Funding

Guizhou Province Science and Technology Support Program Qiankehe (2018)2819
6 · The paper itself

Abstract

backgroundSocioeconomic status (SES) and family relationships are critical social determinants of health disparities. The mechanisms underlying their interactions remain insufficiently understood in Asian cultures with prevalent intergenerational cohabitation. This study investigates the independent and combined effects of SES and family relationships on all-cause mortality in China.

methodsA baseline survey was conducted in 2010 involving 9280 adult permanent residents from 12 counties (districts) in Guizhou Province, using stratified cluster random sampling. Two follow-ups (2016-2020, 2023) were conducted. SES was assessed using a composite score comprising household income, education, and occupation, while family relationships were classified as either "good" or "mediocre." The Cox proportional hazards model was employed to evaluate the independent and combined effects of SES and family relationships on all-cause mortality.

resultsAmong 5949 participants were included, and the cumulative mortality rate was 6.4% over a median follow-up of 12 years. With a decrease in mortality risk as SES increased (P < 0.001). Compared with SES ≤ 6, mortality risk with SES scores of 7, 8, and ≥ 9 decreased by 36.9% (HR = 0.631, 95% CI = 0.473-0.842), 36.6% (HR = 0.644, 95% CI = 0.469-0.886), and 73% (HR = 0.270, 95% CI = 0.183-0.397), respectively. The independent effect of family relationship on the risk of death was not statistically significant (HR = 0.847, 95% CI = 0.0.670- 1.070). The joint analysis showed the compensatory effect was significant when SES exceeded a threshold (SES ≥ 9), alleviating the mortality risk associated with family relationships (HR = 0.2197, 95% CI = 0.073-0.652).

conclusionFindings demonstrate SES independently reduces mortality in Chinese populations, while the effect of family relationships is modulated by cultural background. The resource substitution hypothesis is valid at specific SES thresholds. Intervention efforts should prioritize the vulnerable group characterized by "low SES and weak family support".

Indexed as

All-cause mortalityFamily tiesIntergenerational cohabitationResource substitution hypothesisSocioeconomic position

Identifiers

PMID40660323
PMCPMC12261701

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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.