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

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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.

Original languageEnglish
Pages (from-to)1-12
Number of pages12
JournalInternational Journal of Public Health
DOIs
Publication statusAccepted/In press - Apr 18 2016

Keywords

  • Education
  • Income
  • Interaction
  • Mortality

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health(social science)

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