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Health Behaviours, Socioeconomic Status, and Mortality: Further Analyses of the British Whitehall II and the French GAZEL Prospective Cohorts

Author

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  • Silvia Stringhini
  • Aline Dugravot
  • Martin Shipley
  • Marcel Goldberg
  • Marie Zins
  • Mika Kivimäki
  • Michael Marmot
  • Séverine Sabia
  • Archana Singh-Manoux

Abstract

Further analysis of data from two prospective cohorts reveals differences in the extent to which health behaviors attenuate associations between socioeconomic position and mortality outcomes.Background: Differences in morbidity and mortality between socioeconomic groups constitute one of the most consistent findings of epidemiologic research. However, research on social inequalities in health has yet to provide a comprehensive understanding of the mechanisms underlying this association. In recent analysis, we showed health behaviours, assessed longitudinally over the follow-up, to explain a major proportion of the association of socioeconomic status (SES) with mortality in the British Whitehall II study. However, whether health behaviours are equally important mediators of the SES-mortality association in different cultural settings remains unknown. In the present paper, we examine this issue in Whitehall II and another prospective European cohort, the French GAZEL study. Methods and Findings: We included 9,771 participants from the Whitehall II study and 17,760 from the GAZEL study. Over the follow-up (mean 19.5 y in Whitehall II and 16.5 y in GAZEL), health behaviours (smoking, alcohol consumption, diet, and physical activity), were assessed longitudinally. Occupation (in the main analysis), education, and income (supplementary analysis) were the markers of SES. The socioeconomic gradient in smoking was greater (p

Suggested Citation

  • Silvia Stringhini & Aline Dugravot & Martin Shipley & Marcel Goldberg & Marie Zins & Mika Kivimäki & Michael Marmot & Séverine Sabia & Archana Singh-Manoux, 2011. "Health Behaviours, Socioeconomic Status, and Mortality: Further Analyses of the British Whitehall II and the French GAZEL Prospective Cohorts," PLOS Medicine, Public Library of Science, vol. 8(2), pages 1-1, February.
    • Handle: RePEc:plo:pmed00:1000419
    DOI: 10.1371/journal.pmed.1000419
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    Cited by:

    1. Mark E. McGovern, 2012. "Don't stress: early life conditions, hypertension and selection into associated risk factors," Working Papers 201223, Geary Institute, University College Dublin.
    2. E Wu & Jun-Tao Ni & Zhao-Hui Zhu & Hong-Quan Xu & Lin Tao & Tian Xie, 2022. "Association of a Healthy Lifestyle with All-Cause, Cause-Specific Mortality and Incident Cancer among Individuals with Metabolic Syndrome: A Prospective Cohort Study in UK Biobank," IJERPH, MDPI, vol. 19(16), pages 1-16, August.
    3. Mengfei Liu & Chanyuan Zhang & Hong Cai & Fangfang Liu & Ying Liu & Jingjing Li & Yaqi Pan & Chuanhai Guo & Zhonghu He & Yang Ke, 2016. "The Willingness to Change Risky Health Behaviors among Chinese Rural Residents: What We Learned from a Population-Based Esophageal Cancer Cohort Study," PLOS ONE, Public Library of Science, vol. 11(8), pages 1-11, August.
    4. Ragna Stalsberg & Arve Vorland Pedersen, 2018. "Are Differences in Physical Activity across Socioeconomic Groups Associated with Choice of Physical Activity Variables to Report?," IJERPH, MDPI, vol. 15(5), pages 1-23, May.
    5. Gugushvili, Alexi & Zelinska, Olga & Präg, Patrick & Bulczak, Grzegorz, 2022. "Does perceived social mobility affect health? Evidence from a fixed effects approach," Social Science & Medicine, Elsevier, vol. 294(C).
    6. Cristiano Piccinelli & Paolo Carnà & Silvia Stringhini & Gabriella Sebastiani & Moreno Demaria & Michele Marra & Giuseppe Costa & Angelo d’Errico, 2018. "The contribution of behavioural and metabolic risk factors to socioeconomic inequalities in mortality: the Italian Longitudinal Study," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 63(3), pages 325-335, April.
    7. Egger, Garry & Swinburn, Boyd & Amirul Islam, F.M., 2012. "Economic growth and obesity: An interesting relationship with world-wide implications," Economics & Human Biology, Elsevier, vol. 10(2), pages 147-153.
    8. Éva Bíró & Sándor Kovács & Ilona Veres-Balajti & Róza Ádány & Karolina Kósa, 2021. "Modelling Health in University Students: Are Young Women More Complicated Than Men?," IJERPH, MDPI, vol. 18(14), pages 1-12, July.
    9. Mar Pujades-Rodriguez & Adam Timmis & Dimitris Stogiannis & Eleni Rapsomaniki & Spiros Denaxas & Anoop Shah & Gene Feder & Mika Kivimaki & Harry Hemingway, 2014. "Socioeconomic Deprivation and the Incidence of 12 Cardiovascular Diseases in 1.9 Million Women and Men: Implications for Risk Prediction and Prevention," PLOS ONE, Public Library of Science, vol. 9(8), pages 1-12, August.
    10. Silvia Stringhini & Valentin Rousson & Bharathi Viswanathan & Jude Gedeon & Fred Paccaud & Pascal Bovet, 2014. "Association of Socioeconomic Status with Overall and Cause Specific Mortality in the Republic of Seychelles: Results from a Cohort Study in the African Region," PLOS ONE, Public Library of Science, vol. 9(7), pages 1-8, July.
    11. Silvia Stringhini & Brenda Spencer & Pedro Marques-Vidal & Gerard Waeber & Peter Vollenweider & Fred Paccaud & Pascal Bovet, 2012. "Age and Gender Differences in the Social Patterning of Cardiovascular Risk Factors in Switzerland: The CoLaus Study," PLOS ONE, Public Library of Science, vol. 7(11), pages 1-9, November.
    12. Nina Van der Vliet & Brigit Staatsen & Hanneke Kruize & George Morris & Caroline Costongs & Ruth Bell & Sibila Marques & Timothy Taylor & Sonia Quiroga & Pablo Martinez Juarez & Vojtech Máca & Milan Š, 2018. "The INHERIT Model: A Tool to Jointly Improve Health, Environmental Sustainability and Health Equity through Behavior and Lifestyle Change," IJERPH, MDPI, vol. 15(7), pages 1-21, July.
    13. Terje P. Hagen & Unto Häkkinen & Tor Iversen & Søren Toksvig Klitkou & Tron Anders Moger & on behalf of the EuroHOPE study group, 2015. "Socio‐economic Inequality in the Use of Procedures and Mortality Among AMI Patients: Quantifying the Effects Along Different Paths," Health Economics, John Wiley & Sons, Ltd., vol. 24(S2), pages 102-115, December.
    14. Valentina Gallo & Johan P Mackenbach & Majid Ezzati & Gwenn Menvielle & Anton E Kunst & Sabine Rohrmann & Rudolf Kaaks & Birgit Teucher & Heiner Boeing & Manuela M Bergmann & Anne Tjønneland & Susanne, 2012. "Social Inequalities and Mortality in Europe – Results from a Large Multi-National Cohort," PLOS ONE, Public Library of Science, vol. 7(7), pages 1-10, July.
    15. Terje A Eikemo & Rasmus Hoffmann & Margarete C Kulik & Ivana Kulhánová & Marlen Toch-Marquardt & Gwenn Menvielle & Caspar Looman & Domantas Jasilionis & Pekka Martikainen & Olle Lundberg & Johan P Mac, 2014. "How Can Inequalities in Mortality Be Reduced? A Quantitative Analysis of 6 Risk Factors in 21 European Populations," PLOS ONE, Public Library of Science, vol. 9(11), pages 1-1, November.

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