INCOME, RACE, AND MORTALITY

This study was undertaken to clarify the complex relationship between poverty and race with disease-specific mortality. Data from the 1987 N ational Health Interview Survey and the 1986 National Mortality Follow back Survey were used to estimate standardized mortality ratios (SMRs) . for various categories (all causes, a cancers, noncancerous medical causes, lung and breast cancers, ischemic heart disease, and cerebrova scular disease) associated with income below the poverty line and were compared with those with adequate or better than adequate income. All SMRs were substantially elevated. The SMRs were not appreciably affec ted by adjustments for confounding by alcohol consumption, occupation, or smoking. Sex-specific SMRs of blacks relative to whites with the e xception of ischemic heart disease were significantly elevated for mal es but not for females with the exception of the SMR for all causes. H owever, when adjusted for per capita income within the family, black m ortality never significantly exceeded that of whites. These results st rongly support the conclusion that mortality differences between black s and whites are due to differences in income and related factors. How ever, it is unclear why poverty should be associated with elevation in cancer relative risk.