Education and income influence the black–white crossover in mortality at advanced ages
Blacks generally have higher rates of mortality than whites in the United States during the course of their life. However, evidence indicates a mortality "crossover" that occurs when elevated age-specific mortality rates among blacks invert with those of whites at advanced ages. A new study reveals that this crossover is influenced by income in elderly men, but not elderly women. The researchers used data on 4,162 elderly individuals in North Carolina enrolled in an ongoing epidemiologic study. The individuals were interviewed at baseline (age 65 and older) in 1986–1987, with follow-up interviews in 1989, 1992, and 1996. A significantly higher proportion of blacks (84 percent of black men and 86 percent of black women) than whites (65 percent of white men and 63 percent of white women) had less than 12 years of education ("low education"). Also, 74 percent of black women and 47 percent of black men had income below $7,000 per year compared with 45 percent of white women and 20 percent of white men.
The association between low education and mortality did not vary by race or age and was only significant for men. A significantly higher proportion of black men than white men died during the study period, but there was no racial difference in mortality for women. Blacks had a greater risk of death at age 65 compared with whites (39 percent higher for men, 64 percent higher for women), but the increased risk of death with age was smaller for blacks than whites (2 percent less for men, 3 percent less for women), resulting in a crossover at age 79 years for men and 83 years for women. Low education did not change the increase in mortality with age. When income was taken into account, the increased risk of death with age associated with low income was 38 percent weaker for black men than white men. The interaction between race and income moved the crossover for men to before age 65 years. The study was funded in part by the Agency for Healthcare Research and Quality (T32 HS00079).
More details are in "Socioeconomic status and the black–white mortality crossover," by Jessica M. Sautter, Ph.D., Patricia A. Thomas, Ph.D., Matthew E. Dupre, Ph.D., and Linda K. George, Ph.D., in the August 2012 American Journal of Public Health 202(8), pp. 1566-1571.