摘要：Objectives. We investigated mortality differences according to socioeconomic status (SES) for employed persons in 27 states during 1984–1997. Methods. SES was determined for persons aged 35–64 years according to the “usual occupation” listed on their death certificates. We used US Census denominator data. Results. For all-cause mortality, rate ratios from lowest to highest SES quartile for men and women were 2.02, 1.69, 1.25, and 1.00 and 1.29, 1.01, 1.07, and 1.00, respectively. Percentage of all deaths attributable to being in the lowest 3 SES quartiles was 27%. Inverse SES gradients were strong for most major causes of death except breast cancer and colorectal cancer. Heart disease mortality for highest and lowest SES quartiles dropped 45% and 25%, respectively, between 1984 and 1997. Conclusions. Mortality differences by SES were sustained through the 1990s and are increasing for men. Several large cohort studies in the United States have shown that mortality rates are higher among those of low versus high socioeconomic status (SES). Higher levels of standard risk factors for those with low SES do not appear to entirely account for this fact. 1– 5 Several studies have also considered temporal changes in mortality by SES and have shown that cardiovascular mortality has been decreasing faster for higher-SES groups from the 1950s to the 1980s. 6– 10 Few data on SES and mortality have been published in recent years. The only study to have yielded more recent data was based on the American Cancer Society population, which has a higher SES than the general population. We examined whether previously observed SES differences in mortality persisted during the 1990s and how these differences changed over time in a population reasonably representative of the US population: employed persons aged 35–64 years in 27 states during the period 1984–1997.
