Socioeconomic risk for mortality

Wednesday February 1st, 2017

Socioeconomic status must be a major focus of health strategies to reduce mortality, experts say today.

Writing in The Lancet, experts say that economic status should be regarded as a modifiable risk factor.

Currently, the World Health Organisation targets seven major risk factors in the prevention and control of non-communicable diseases. These are: alcohol use, physical inactivity, tobacco use, blood pressure, salt/sodium intake, diabetes, and obesity.

But Dr Silvia Stringhini of Lausanne University Hospital, Switzerland, and colleagues write in today's Lancet that: "Socioeconomic circumstances and their consequences are modifiable by policies at the local, national, and international levels."

The team compared the impact of socioeconomic status on mortality and years-of-life-lost, compared with the conventional risk factors, using figures from 48 long-term studies covering 1,751,479 men and women in seven high-income countries.

This showed that people with low socioeconomic status had up to 42% higher mortality than those with high socioeconomic status.

Once the conventional risk factors were taken into account, the risk was still raised by 26%. Low socioeconomic status was the third most significant risk factor, after smoking and physical inactivity.

"Socioeconomic circumstances, in addition to the seven conventional risk factors, should be targeted by local and global health strategies and health risk surveillance to reduce mortality," the researchers conclude.

"Given the huge impact of socioeconomic status on health, it's vital that governments accept it as a major risk factor and stop excluding it from health policy," said Silvia Stringhini. "Reducing poverty, improving education and creating safe home, school and work environments are central to overcoming the impact of socioeconomic deprivation. By doing this, socioeconomic status could be targeted and improved, leading to better wealth and health for many."

Dr Emily Burns, from Diabetes UK, said: “It’s important for public health bodies working to improve global health to consider the factors that reduce life expectancy, but separating the impact of factors like smoking or obesity from socioeconomic status is really difficult."

Stringhini, S. et al. Socioeconomic status and the 25 × 25 risk factors as determinants of premature mortality: a multicohort study and meta-analysis of 1.7 million men and women. The Lancet 1 February 2017; doi: 10.1016/S0140-6736(16)32380-7 [abstract]

Tags: Europe | General Health

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