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

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  • Luisa N Borrell
  • Elena Rodríguez-Álvarez
  • Florence J Dallo

Abstract

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.

Suggested Citation

  • Luisa N Borrell & Elena Rodríguez-Álvarez & Florence J Dallo, 2020. "Racial/ethnic inequities in the associations of allostatic load with all-cause and cardiovascular-specific mortality risk in U.S. adults," PLOS ONE, Public Library of Science, vol. 15(2), pages 1-14, February.
  • Handle: RePEc:plo:pone00:0228336
    DOI: 10.1371/journal.pone.0228336
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    References listed on IDEAS

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    1. Barboza Solís, Cristina & Fantin, Romain & Castagné, Raphaële & Lang, Thierry & Delpierre, Cyrille & Kelly-Irving, Michelle, 2016. "Mediating pathways between parental socio-economic position and allostatic load in mid-life: Findings from the 1958 British birth cohort," Social Science & Medicine, Elsevier, vol. 165(C), pages 19-27.
    2. Geronimus, A.T. & Hicken, M. & Keene, D. & Bound, J., 2006. ""Weathering" and age patterns of allostatic load scores among blacks and whites in the United States," American Journal of Public Health, American Public Health Association, vol. 96(5), pages 826-833.
    3. Fox, M. & Entringer, S. & Buss, C. & DeHaene, J. & Wadhwa, P.D., 2015. "Intergenerational transmission of the effects of acculturation on health in Hispanic Americans: a fetal programming perspective," American Journal of Public Health, American Public Health Association, vol. 105, pages 409-423.
    4. Fox, M. & Entringer, S. & Buss, C. & DeHaene, J. & Wadhwa, P.D., 2015. "Intergenerational transmission of the effects of acculturation on health in hispanic Americans: A fetal programming perspective," American Journal of Public Health, American Public Health Association, vol. 105, pages 409-423.
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    1. Emmanuel Obeng-Gyasi & Alesia C. Ferguson & Katherine A. Stamatakis & Michael A. Province, 2021. "Combined Effect of Lead Exposure and Allostatic Load on Cardiovascular Disease Mortality—A Preliminary Study," IJERPH, MDPI, vol. 18(13), pages 1-9, June.

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