Impact of education, income and chronic disease risk factors on mortality of adults: Does 'a pauper-rich paradox' exist in Latin American societies?

Abstract

Objectives: To test the hypothesis that an inverse association exists between socio-economic position and all-cause mortality in a developing country in Latin America. Study design: Prospective cohort study carried out in Chile using data from a simple random sample of 920 apparently healthy subjects (weighted population 11,600 aged 30-89 years) followed for 8 years. Methods: Education level (0-8 years, 9-12 years and ≥13 years) and income quartiles were established at the outset of the study, along with behavioural and biological risk factors for chronic diseases: smoking, alcohol use, obesity, diabetes, hypertension, lipids and family history of death by cardiovascular disease. Relative risks of all-cause mortality were estimated using age-adjusted Cox regression models. Results: During the follow-up period, 46 deaths were observed. Adjusting for age, gender, and behavioural and biological risk factors, the mortality risk for increasing categories of education after controlling for i