Research report
Decline of the relative risk of death associated with low
employment grade at older age: the impact of age related differences in
smoking, blood pressure and plasma cholesterol
P J Marang-van de Mheena, M J Shipleyb, J C M Wittemanc, M G Marmotb, L J Gunning-Schepersa
a Department of Social
Medicine, Academic Medical Centre, PO Box 22660, 1100 DD Amsterdam, the
Netherlands, b Department of Epidemiology and
Public Health, University College London Medical School, UK, c Department of
Epidemiology and Biostatistics, Erasmus University Medical School,
Rotterdam, the Netherlands
Correspondence to: Dr Marang-van de Mheen (p.j.vandemheen{at}amc.uva.nl)
Accepted for publication 24 August 2000
STUDY OBJECTIVE
To
explore whether the observed age related decline in the relative risk
of death associated with low employment grade can be explained by the
profiles of smoking, blood pressure and plasma cholesterol changing
differently with age between the employment grades.
DESIGNProspective
cohort study with 25 years of mortality follow up.
SETTINGWhitehall study.
PARTICIPANTSThere
were 16 984 men aged 40 to 69 years at baseline with complete
information on smoking, blood pressure and plasma cholesterol.
MAIN RESULTSThe
relative risk of death associated with low employment grade decreased
from 2.1 at 55-59 years of age to 1.3 at 85-89 years of age.
Adjustment for smoking status and blood pressure, attenuated the age
related decline of the relative risk by 18% and 3% respectively; adjustment for plasma cholesterol increased the decline by 3%. Taken
together, these risk factors explain 20% of the observed age related decline.
CONCLUSIONSA small
part of the observed age related decline in the relative risk of death
associated with low employment grade can be explained by differential
changes in the profiles of smoking, blood pressure and plasma
cholesterol with age between the employment grades.
Keywords: relative risk; risk factors; socioeconomic status; differential mortality
© 2001 by Journal of Epidemiology and Community Health
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