PDF(Pubmed)
Abstract：
Socioeconomic status (SES) has been linked to mortality rates, with family income being a quantifiable marker of SES. However, the precise association between the family income-to-poverty ratio (PIR) and all-cause mortality in adults aged 40 and older remains unclear. A cross-sectional study was conducted using data from NHANES III, including 20,497 individuals. The PIR was used to assess financial status, and various demographic, lifestyle, and clinical factors were considered. Mortality data were collected from the NHANES III linked mortality file. The study revealed a non-linear association between PIR and all-cause mortality. The piecewise Cox proportional hazards regression model showed an inflection point at PIR 3.5. Below this threshold, the hazard ratio (HR) for all-cause mortality was 0.85 (95% CI 0.79-0.91), while above 3.5, the HR decreased to 0.66 (95% CI 0.57-0.76). Participants with lower income had a higher probability of all-cause mortality, with middle-income and high-income groups showing lower multivariate-adjusted HRs compared to the low-income group. This study provides evidence of a non-linear association between PIR and all-cause mortality in adults aged 40 and older, with an inflection point at PIR 3.5. These findings emphasize the importance of considering the non-linear relationship between family income and mortality when addressing socioeconomic health disparities.
摘要：
社会经济地位（SES）与死亡率有关，家庭收入是SES的可量化标志。然而,家庭收入-贫困比(PIR)与40岁及以上成人全因死亡率之间的确切关联尚不清楚.使用NHANESIII的数据进行了一项横断面研究，包括20497人。PIR用于评估财务状况，和各种人口统计学，生活方式,并考虑了临床因素。死亡率数据收集自NHANESIII相关死亡率档案。该研究揭示了PIR和全因死亡率之间的非线性关联。分段Cox比例风险回归模型在PIR3.5处显示拐点。低于这个门槛，全因死亡率的风险比（HR）为0.85（95％CI0.79-0.91），当高于3.5时，HR降至0.66(95%CI0.57-0.76)。收入较低的参与者全因死亡率的可能性较高，与低收入组相比，中等收入和高收入组的多变量调整后的HR较低。这项研究提供的证据表明，在40岁及以上的成年人中，PIR与全因死亡率之间存在非线性关联。拐点在PIR3.5。这些发现强调了在解决社会经济健康差异时考虑家庭收入与死亡率之间的非线性关系的重要性。
