American Journal of Epidemiology Advance Access originally published online on August 2, 2005
American Journal of Epidemiology 2005 162(6):569-578; doi:10.1093/aje/kwi220
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ORIGINAL CONTRIBUTIONS |
Latino Risk-adjusted Mortality in the Men Screened for the Multiple Risk Factor Intervention Trial
1 Coordinating Centers for Biometric Research, Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN
2 Department of Social Medicine, University of Bristol, Bristol BS8 2PR, United Kingdom
Correspondence to Avis Thomas, University of Minnesota, 2221 University Avenue, Suite 200, Minneapolis, MN 55414 (e-mail: avist{at}ccbr.umn.edu).
Latinos are now the largest minority in the United States, but their distinctive health needs and mortality patterns remain poorly understood. Proportional hazards regressions were used to compare Latino versus White risk- and income-adjusted mortality over 25 years' follow-up from 5,846 Latino and 300,647 White men screened for the Multiple Risk Factor Intervention Trial. Men were aged 35–57 years and residing in 14 states when screened in 1973–1975. Data on coronary heart disease risk factors, self-reported race/ethnicity, and home addresses were obtained at baseline; income was estimated by linking addresses to census data. Mortality follow-up through 1999 was obtained using the National Death Index. The fully adjusted Latino/White hazard ratio for all-cause mortality was 0.82 (95% confidence interval (CI): 0.77, 0.87), based on 1,085 Latino and 73,807 White deaths; this pattern prevailed over time and across states (thus, likely across Latino subgroups). Hazard ratios were significantly greater than one for stroke (hazard ratio = 1.30, 95% CI: 1.01, 1.68), liver cancer (hazard ratio = 2.02, 95% CI: 1.21, 3.37), and infection (hazard ratio = 1.69, 95% CI: 1.24, 2.32). A substudy found only minor racial/ethnic differences in the quality of Social Security numbers, birth dates, soundex-adjusted names, and National Death Index searches. Results were not likely an artifact of return migration or incomplete mortality data.
cardiovascular diseases; cerebrovascular accident; diabetes mellitus, type 2; emigration and immigration; ethnology; Hispanic Americans; liver neoplasms; social class
Abbreviations: CI, confidence interval; MRFIT, Multiple Risk Factor Intervention Trial
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