Socioeconomic status, race, and mortality: a prospective cohort study

Am J Public Health. 2014 Dec;104(12):e98-e107. doi: 10.2105/AJPH.2014.302156. Epub 2014 Oct 16.


Objectives: We evaluated the independent and joint effects of race, individual socioeconomic status (SES), and neighborhood SES on mortality risk.

Methods: We conducted a prospective analysis involving 52 965 non-Hispanic Black and 23 592 non-Hispanic White adults taking part in the Southern Community Cohort Study. Cox proportional hazards modeling was used to determine associations of race and SES with all-cause and cause-specific mortality.

Results: In our cohort, wherein Blacks and Whites had similar individual SES, Blacks were less likely than Whites to die during the follow-up period (hazard ratio [HR] = 0.78; 95% confidence interval [CI] = 0.73, 0.84). Low household income was a strong predictor of all-cause mortality among both Blacks and Whites (HR = 1.76; 95% CI = 1.45, 2.12). Being in the lowest (vs highest) category with respect to both individual and neighborhood SES was associated with a nearly 3-fold increase in all-cause mortality risk (HR = 2.76; 95% CI = 1.99, 3.84). There was no significant mortality-related interaction between individual SES and neighborhood SES among either Blacks or Whites.

Conclusions: SES is a strong predictor of premature mortality, and the independent associations of individual SES and neighborhood SES with mortality risk are similar for Blacks and Whites.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Black or African American / statistics & numerical data*
  • Demography
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mortality / trends*
  • Prospective Studies
  • Risk Factors
  • Social Class*
  • United States / epidemiology
  • White People / statistics & numerical data*