Citation

Roy B, Kiefe CI, Jacobs DR, Goff DC, Lloyd-Jones D, Shikany JM, Reis JP, Gordon-Larsen P, Lewis CE. Am. J. Public Health 2020; ePub(ePub): e1-e7.

Affiliation

Brita Roy is with the Department of Internal Medicine, Yale School of Medicine, New Haven, CT. Catarina I. Kiefe is with the Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA. David R. Jacobs is with the Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis. During the time of the study, David C. Goff was with the Colorado School of Public Health, University of Colorado, Aurora, and the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD. Donald Lloyd-Jones is with the Feinberg School of Medicine, Northwestern University, Evanston, IL. James M. Shikany is with the Division of Preventive Medicine, University of Alabama at Birmingham. Jared P. Reis is with the National Heart, Lung, and Blood Institute. Penny Gordon-Larsen is with the Department of Nutrition, Gillings School of Global Public Health, University of North Carolina-Chapel Hill. Cora E. Lewis is with the Department of Epidemiology, School of Public Health, University of Alabama at Birmingham.

Copyright

(Copyright © 2020, American Public Health Association)

DOI

10.2105/AJPH.2019.305506

PMID

32078342

Abstract

Objectives. To assess causes of premature death and whether race/ethnicity or education is more strongly and independently associated with premature mortality in a diverse sample of middle-aged adults in the United States.Methods. The Coronary Artery Risk Development in Young Adults study (CARDIA) is a longitudinal cohort study of 5114 participants recruited in 1985 to 1986 and followed for up to 29 years, with rigorous ascertainment of all deaths; recruitment was balanced regarding sex, Black and White race/ethnicity, education level (high school or less vs. greater than high school), and age group (18-24 and 25-30 years). This analysis included all 349 deaths that had been fully reviewed through month 348. Our primary outcome was years of potential life lost (YPLL).Results. The age-adjusted mortality rate per 1000 persons was 45.17 among Black men, 25.20 among White men, 17.63 among Black women, and 10.10 among White women. Homicide and AIDS were associated with the most YPLL, but cancer and cardiovascular disease were the most common causes of death. In multivariable models, each level of education achieved was associated with 1.37 fewer YPLL (P = .007); race/ethnicity was not independently associated with YPLL.Conclusions. Lower education level was an independent predictor of greater YPLL. (Am J Public Health. Published online ahead of print February 20, 2020: e1-e7. doi:10.2105/AJPH.2019.305506).

Language: en