Health Behaviours, Socioeconomic Status, and Mortality Further Analyses of the British Whitehall II and the French GAZEL Prospective Cohorts 英文参考文献.docVIP

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Health Behaviours, Socioeconomic Status, and Mortality Further Analyses of the British Whitehall II and the French GAZEL Prospective Cohorts 英文参考文献.doc

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Health Behaviours, Socioeconomic Status, and Mortality Further Analyses of the British Whitehall II and the French GAZEL Prospective Cohorts 英文参考文献

HealthBehaviours,SocioeconomicStatus,andMortality: FurtherAnalysesoftheBritishWhitehallIIandthe FrenchGAZELProspectiveCohorts SilviaStringhini1*,AlineDugravot1,MartinShipley2,MarcelGoldberg1,MarieZins1,MikaKivima¨ki2, MichaelMarmot2,Se′verineSabia1,ArchanaSingh-Manoux1,2,3 1INSERMU1018,CentreforResearchinEpidemiologyandPopulationHealth,Ho?pitalPaulBrousse,Villejuif,France,2DepartmentofEpidemiologyandPublicHealth, UniversityCollegeLondon,London,UnitedKingdom,3CentredeGe′rontologie,Ho?pitalSaintePe′rine, AssistancePublique-Ho?pitauxdeParis,Paris,France Abstract Background:Differencesinmorbidityandmortalitybetweensocioeconomicgroupsconstituteoneofthemostconsistent findingsofepidemiologicresearch.However,researchonsocialinequalitiesinhealthhasyettoprovideacomprehensive understandingofthemechanismsunderlyingthisassociation.Inrecentanalysis,weshowedhealthbehaviours,assessed longitudinally over the follow-up, to explain a major proportion of the association of socioeconomic status (SES) with mortalityintheBritishWhitehallIIstudy.However,whetherhealthbehavioursareequallyimportantmediatorsoftheSES- mortalityassociationindifferentculturalsettingsremainsunknown.Inthepresentpaper,weexaminethisissueinWhitehall IIandanotherprospectiveEuropeancohort,theFrenchGAZELstudy. MethodsandFindings:Weincluded9,771participantsfromtheWhitehallIIstudyand17,760fromtheGAZELstudy.Over thefollow-up(mean19.5yinWhitehallIIand16.5yinGAZEL),healthbehaviours(smoking,alcoholconsumption,diet,and physicalactivity),wereassessedlongitudinally.Occupation(inthemainanalysis),education,andincome(supplementary analysis)werethemarkersofSES.Thesocioeconomicgradientinsmokingwasgreater(p,0.001)inWhitehallII(oddsratio [OR] =3.68, 95% confidence interval [CI] 3.11–4.36) than in GAZEL (OR =1.33, 95% CI 1.18–1.49); this was also true for unhealthy diet (OR =7.42, 95% CI 5.19–10.60 in Whitehall II and OR =1.31, 95% CI 1.15–1.49 in GAZEL, p,0.001). Socioeconomicdifferencesinmortalityweresimilarinthetwocohorts,ahaz