[Socioeconomic and educational inequities as independent predictors for mortality in a developing country: A cohort study in San Francisco, Chile].
BACKGROUND
The socioeconomic position (SEP) and educational level of individuals have an inverse correlation with mortality in developed societies.


OBJECTIVE
To assess in a society undergoing a socioeconomic transition, the mortality risk associated to a low SEP (combination of education and income, scale 0-25 points, reference > 10 points) and low education (education years, reference > 8 years), adjusting for other known risk factors.


METHODS
In this prospective cohort study, a random sample of 920 subjects, living in San Francisco de Mostazal, Chile, aged more than 20 years (395 males) was examined for the first time in 1997-1999 and re-examined in 2005-2006. All had information about economic household income and level of education. A Cox regression model was used to evaluate the association between mortality and socioeconomic measures.


RESULTS
The crude mortality hazard ratio (HR) was 3.34 (95% confidence interval (CI) 2.88-3.87) and 6.05 (95% CI 5.04-7.26) for low SEP and low educational level, respectively. After adjusting for age, gender, hypertension, diabetes, dyslipidemia, abdominal obesity, smoking, alcohol intake and family history of cardiovascular disease, the figures were 1.23 (95% CI 1.04-1.43) and 1.54 (95% CI 1.23-1.85) for low SEP and low educational level, respectively.


CONCLUSIONS
In a society in socioeconomic transition, low SEP and especially low educational level are risk factors for mortality even after adjusting for known mortality risk factors.
Koch
Elard
E
Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile. ekoch@med.uchile.cl
Romero
Tomás
T
Manríquez
Leopoldo
L
Paredes
Mario
M
Ortúzar
Esteban
E
Taylor
Alan
A
Román
Carolinne
C
Kirschbaum
Aída
A
Díaz
Carlos
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002677:Chile / Q000453:epidemiology; D004522:Educational Status; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D012959:Socioeconomic Factors