Interaction between education and income on the risk of all-cause mortality: prospective results from the MOLI-SANI study

Marialaura Bonaccio (), Augusto Di Castelnuovo, Simona Costanzo, Mariarosaria Persichillo, Maria Benedetta Donati, Giovanni de Gaetano and Licia Iacoviello
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Marialaura Bonaccio: IRCCS Istituto Neurologico Mediterraneo NEUROMED
Augusto Di Castelnuovo: IRCCS Istituto Neurologico Mediterraneo NEUROMED
Simona Costanzo: IRCCS Istituto Neurologico Mediterraneo NEUROMED
Mariarosaria Persichillo: IRCCS Istituto Neurologico Mediterraneo NEUROMED
Maria Benedetta Donati: IRCCS Istituto Neurologico Mediterraneo NEUROMED
Giovanni de Gaetano: IRCCS Istituto Neurologico Mediterraneo NEUROMED
Licia Iacoviello: IRCCS Istituto Neurologico Mediterraneo NEUROMED

International Journal of Public Health, 2016, vol. 61, issue 7, No 5, 765-776

Abstract: Abstract Objectives To investigate the separate and inter-related associations of education and household income in relation to all-cause mortality. Methods Prospective study on 16,247 men and women (≥35 years), a sub-sample of the MOLI-SANI cohort that had been randomly recruited within an Italian general population. Both education and income were used as categorical variables. Hazard ratios (HR) were calculated by Cox-proportional hazard models. Results Over a median follow-up of 7.7 years (125,016 person-years), 694 deaths were ascertained. Either education (HR = 0.68; 95 % CI 0.51–0.91) or income (HR = 0.57; 0.42–0.77) was inversely associated with mortality. After simultaneous adjustment, the association of education appeared to be largely explained by income. A significant interaction between both variables was found (p = 0.0078). The inverse association with mortality was stronger when a higher income was combined with a higher educational level (HR = 0.59; 0.38–0.92 for the highest combination of the two indicators). Conclusions Either education or income was the predictor of mortality in a large sample of the Italian population. The two variables significantly interacted and the inverse association of income with mortality tended to be stronger within higher education groups.

Keywords: Education; Income; Interaction; Mortality (search for similar items in EconPapers)
Date: 2016
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DOI: 10.1007/s00038-016-0822-z

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