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Member Research & Reports

Member Research & Reports

UAB: Education, Race/Ethnicity, and Causes of Premature Mortality Among Middle-Aged Adults in 4 US Urban Communities: Results From CARDIA, 1985-2017

This study assesses the causes of premature death and whether race/ethnicity or education is more strongly and independently associated with premature mortality in a diverse sample of middle-aged adults in the United States. Depending on race/ethnicity, education, and place of residence, Americans experience up to 30-year differences in life expectancy at birth.

A team of researchers collaborated on this study, including Dr. Cora E. Lewis, Department of Epidemiology, University of Alabama at Birmingham School of Public Health and Dr. James Shikany, Division of Preventive Medicine, at UAB.

The Coronary Artery Risk Development in Young Adults study (CARDIA) is a longitudinal cohort of equally represented Black and White men and women of higher and lower educational attainment who were recruited from 4 urban centers at ages 18 to 30 years. Data from this cohort provide a rare opportunity to identify predictors of and causes of premature mortality among Black and White men and women before the age of 60 years.

Homicide and acquired immune deficiency syndrome (AIDS) were associated with the most years of potential life lost (YPLL), but cancer and cardiovascular disease were the most common causes of death. Lower education level was an independent predictor of greater YPLL.

They found evidence of persistent race/ethnicity–related and education related disparities in premature mortality. Education accounts for most of the observed racial/ethnic disparities. City-level policies that support the achievement of equality in educational attainment — for example, increasing affordable housing options and access to high-quality early childhood education — are testable approaches to eliminating observed racial/ethnic disparities in health and longevity.

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