Racial/ethnic inequities in the associations of allostatic load with all-cause and cardiovascular-specific mortality risk in U.S. adults

Non-Hispanic blacks have higher mortality rates than non-Hispanic whites whereas Hispanics have similar or lower mortality rates than non-Hispanic blacks and whites despite Hispanics' lower education and access to health insurance coverage. This study examines whether allostatic load, a proxy f...

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Bibliographic Details
Published in:PloS one 2020-02, Vol.15 (2), p.e0228336
Main Authors: Borrell, Luisa N, Rodríguez-Álvarez, Elena, Dallo, Florence J
Format: Article
Language:English
Subjects:
Adult
Adults
African Americans
Age
Aged
Allostasis
Biology and Life Sciences
Biomarkers
Blood pressure
Cardiovascular diseases
Cardiovascular Diseases - ethnology
Cardiovascular Diseases - mortality
Cardiovascular Diseases - physiopathology
Datasets
Disease
Education
Educational attainment
Ethnicity
Ethnicity - statistics & numerical data
Female
Health risks
Healthcare Disparities - statistics & numerical data
Hemoglobin
Hispanic Americans
Humans
Hypotheses
Male
Marital status
Medicine and Health Sciences
Middle Aged
Minority & ethnic groups
Mortality
People and places
Physiology
Race
Racial Groups - statistics & numerical data
Risk
Risk groups
Sex
Social Sciences
Socioeconomic factors
United States - epidemiology
United States - ethnology
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Summary:Non-Hispanic blacks have higher mortality rates than non-Hispanic whites whereas Hispanics have similar or lower mortality rates than non-Hispanic blacks and whites despite Hispanics' lower education and access to health insurance coverage. This study examines whether allostatic load, a proxy for cumulative biological risk, is associated with all-cause and cardiovascular (CVD)-specific mortality risks in US adults; and whether these associations vary with race/ethnicity and further with age, sex and education across racial/ethnic groups. Data from the third National Health and Nutritional Examination Survey (NHANES III, 1988-1994) and the 2015 Linked Mortality File were used for adults 25 years or older (n = 13,673 with 6,026 deaths). Cox proportional hazards regression was used to estimate the associations of allostatic load scores (2 and ≥3 relative to ≤1) with a) all-cause and b) CVD-specific mortality risk among NHANES III participants before and after controlling for selected characteristics. Allostatic load scores are associated with higher all-cause and CVD-specific mortality rates among U.S. adults aged 25 years or older, with stronger rates observed for CVD-specific mortality. All-cause mortality rates for each racial/ethnic group differed with age and education whereas for CVD-specific mortality rates, this difference was observed for sex. Our findings of high allostatic load scores associated with all-cause and CVD-specific mortality among US adults call attention to monitor conditions associated with the allostatic load's biomarkers to identify high-risk groups to help monitor social inequities in mortality risk, especially premature mortality.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0228336