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Cumulative biological riskand socio-economic differences in mortality



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ARTICLE IN PRESS Social Science Medicine 58 2004 1985 1997 Cumulative biological risk and socio economic differences in mortality MacArthur Studies of Successful Aging Teresa E Seemana Eileen Crimminsb Mei Hua Huanga Burton Singerc Alexander Bucura Tara Gruenewaldd Lisa F Berkmane David B Reubena a Division of Geriatrics Geffen School of Medicine University of California 10945 Le Conte Ave Suite 2339 Los Angeles CA 90095 1687 USA b Andrus Gerontology Center University of Southern California Los Angeles CA USA c Office of Population Research Princeton University Princeton NJ USA d Department of Psychology University of California Los Angeles CA USA e Department of Health and Social Behavior School of Public Health Harvard University Cambridge MA USA Abstract Previous research has suggested that socio economic status SES differences in mortality are only partially explained by differences in life style psychological and social factors Seven year mortality data 1988 1995 from the MacArthur Study of Successful Aging a longitudinal study of adults aged 70 79 from New Haven CT East Boston MA and Durham NC were used to test the hypothesis that a cumulative measure of biological dysregulation allostatic load re ecting multiple regulatory systems would serve as a further mediator of SES differences in mortality Logistic regression analyses revealed that a cumulative index of biological risk explained 35 4 of the difference in mortality risk between those with higher versus lower SES as measured by less than high school education versus high school or greater educational attainment Importantly the cumulative index provided independent explanatory power over and above a measure of doctor diagnosed disease though the latter also contributed to education related variation in mortality risks The summary measure of biological risk also accounted for more variance than individual biological parameters suggesting the potential value of a multi systems view of biological pathways



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