How Much of the Correlation Between Socioeconomic Status and Life Expectancy Results from Lifestyle Choice?
Mediation analysis is a statistical technique can be used in an attempt to shed some light on why a correlation between two variables might exist, by involving a third variable that might be causative. In today's open access paper, the correlation of interest is between socioeconomic status and life expectancy, or socioeconomic status and the state of late life health. Socioeconomic status is one of a number of linked traits well established to correlate with longevity, such as wealth, education, and intelligence. How exactly these traits interact with one another and where the various arrows of causation are located, are the subjects of many hypotheses. Unfortunately concrete proof of any sort of causation is challenging to conjure forth from epidemiological databases.
Today's open access paper reports on an effort to seek insight into the degree that the greater life expectancy and lesser burden of age-related disease exhibited by high socioeconomic status study populations is a matter of these individuals tending to make better lifestyle choices, such as in the matter of smoking, diet, weight, exercise, and so forth. The result is interesting in that it suggests only a modest fraction of the differences between socioeconomic groups are caused by lifestyle choice. Other prominent potential causative factors that might differ between socioeconomic groups include exposure to air pollution, exposure to persistent infectious agents, and access to medical resources, all well studied in addition. Again, however, firm conclusions do not tend to emerge from studies of this nature.
Lower socioeconomic status (SES) is associated with various adverse health outcomes, but its association with healthy ageing is less known, and whether adherence to a healthy lifestyle at late-life years can reduce socioeconomic disparities in health requires further investigation. In a 20-year cohort of 33,541 older adults aged ≥65 years across 23 provinces in China, we investigated socioeconomic disparities in mortality and unhealthy ageing considering physical, cognitive, mental, visual, and hearing functions, and evaluated whether adherence to a healthy lifestyle at late-life years can reduce these health disparities.
We categorized SES into low, medium, or high using latent class analysis based on education level, financial status, and occupation, and established the healthy lifestyle score by never smoking, no heavy alcohol consumption, regular physical and leisure activity, and a healthy diet. Compared with older adults of high SES, those of low SES had increased risks of all-cause mortality and unhealthy ageing, with adjusted hazard ratios (HR) of 1.25 and 1.46, respectively. Overall, a healthy lifestyle mediated 20.5% and 16.4% of socioeconomic inequity in all-cause mortality and unhealthy ageing, respectively. In low, medium, and high SES subpopulations, the healthiest lifestyle group had 3.18, 3.76, and 5.65 more years of total life expectancy, and 1.40, 2.73, and 3.90 more years of healthy life expectancy at age 65, respectively, compared to the least healthy group.