Dataset Information

Trends in the educational gradient of mortality among US adults aged 45 to 84 years: bringing regional context into the explanation.

ABSTRACT:

Objectives

We investigated trends in the educational gradient of US adult mortality, which has increased at the national level since the mid-1980s, within US regions.

Methods

We used data from the 1986-2006 National Health Interview Survey Linked Mortality File on non-Hispanic White and Black adults aged 45 to 84 years (n = 498,517). We examined trends in the gradient within 4 US regions by race-gender subgroup by using age-standardized death rates.

Results

Trends in the gradient exhibited a few subtle regional differences. Among women, the gradient was often narrowest in the Northeast. The region's distinction grew over time mainly because low-educated women in the Northeast did not experience a significant increase in mortality like their counterparts in other regions (particularly for White women). Among White men, the gradient narrowed to a small degree in the West.

Conclusions

The subtle regional differences indicate that geographic context can accentuate or suppress trends in the gradient. Studies of smaller areas may provide insights into the specific contextual characteristics (e.g., state tax policies) that have shaped the trends, and thus help explain and reverse the widening mortality disparities among US adults.

SUBMITTER: Montez JK

PROVIDER: S-EPMC3865154 | biostudies-literature | 2014 Jan

REPOSITORIES: biostudies-literature

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Publications

Trends in the educational gradient of mortality among US adults aged 45 to 84 years: bringing regional context into the explanation.

Montez Jennifer Karas JK Berkman Lisa F LF

American journal of public health 20131114 1

<h4>Objectives</h4>We investigated trends in the educational gradient of US adult mortality, which has increased at the national level since the mid-1980s, within US regions.<h4>Methods</h4>We used data from the 1986-2006 National Health Interview Survey Linked Mortality File on non-Hispanic White and Black adults aged 45 to 84 years (n = 498,517). We examined trends in the gradient within 4 US regions by race-gender subgroup by using age-standardized death rates.<h4>Results</h4>Trends in the gr ...[more]

PMID: 24228659

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Project description:A loss of skeletal muscle mass and an increase in intramuscular fat are known to occur as we enter middle and older age, but the expected changes or normative values have remained unknown. The primary reason for this is that imaging studies are difficult and expensive to conduct, and consequently, the sample sizes have remained small. The development of the UK Biobank which provides access to a large magnetic resonance imaging (MRI) data set of more than 50,000 participants provides an opportunity to finally address this question of normative values for each age group. The study's primary aim was to determine the age-related changes in thigh muscle composition (e.g., thigh fat-free muscle volume and intramuscular fat) between the ages of 45 and 84 years. The second aim was to analyse associations between thigh fat-free muscle volume and intramuscular fat with lifestyle behaviours (smoking, alcohol consumption, and physical activity), leg pain, and bone mineral density. Fifty thousand three hundred thirty-two participants were included in the study. Total fat-free thigh muscle declined between the ages of 45 and 84 years, while intramuscular fat of the thigh continued to increase. The changes were stable between these age groups. The mean volume of fat-free muscle ranged from 11.16 (SD: 1.40) to 13.26 L (SD: 1.85) in adult males and 7.60 (SD: 0.97) to 8.80 L (SD 1.29) in females between the ages of 45 and 84 years. For intramuscular fat, the change among women was from 6.94% (SD: 1.59) in the 45 to 54 years age bracket to 8.83% (SD: 1.92) in the 75 to 84 age bracket, while for men, it was 5.83% (SD: 1.30) in the 45 to 54 age bracket to 7.85% (SD 1.89) in the 75 to 84 age bracket. The total fat-free muscle volume and intramuscular fat percentage provided can be used for the purpose of reference standards or normative values for adults in the age groups provided. Fat-free muscle and intramuscular fat were found to be associated with a range of health, activity, and leg pain outcomes, and these should be investigated in a follow-up longitudinal imaging study.

Dataset Information

Trends in the educational gradient of mortality among US adults aged 45 to 84 years: bringing regional context into the explanation.

Objectives

Methods

Results

Conclusions

Publications

Trends in the educational gradient of mortality among US adults aged 45 to 84 years: bringing regional context into the explanation.

Similar Datasets

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