Table_1_Lifestyle behaviors, social and economic disadvantages, and all-cause and cardiovascular mortality: results from the US National Health Interview Survey.docx

AimTo examine the independent relationships of lifestyle and social and economic factors with all-cause and cardiovascular disease (CVD) mortality in a large representative sample of the US adult population. Furthermore, the association between the combination of lifestyle and social and economic factors with mortality was analyzed in detail.
MethodsThe sample included 103,314 participants with valid records and eligible for mortality follow-up, and information on lifestyle factors and social and economic disadvantages (NHIS waves 2000, 2005, 2010, and 2015). An unhealthy lifestyle score was constructed using information on physical activity, alcohol consumption, diet, and smoking status. Social and economic disadvantages were assessed using information on education, receipt of dividends, employment, family's home, and access to private health. Information on mortality data was determined by the National Death Index records.
ResultsCompared with favorable lifestyle, unfavorable lifestyle was associated with higher all-cause (HR 2.07; 95% CI 1.97–2.19) and CVD (HR 1.84; 95% CI 1.68–2.02) mortality. Higher social and economic disadvantages were also associated with higher all-cause (HR 2.44; 95% CI 2.30–2.59) and CVD mortality (HR 2.44; 95% CI 2.16–2.77), compared to low social and economic disadvantages. In joint associations, participants in the high social and economic disadvantage and unfavorable lifestyle showed a greater risk of all-cause (HR 4.06; 95% CI 3.69–4.47) and CVD mortality (HR 3.98; 95% CI 3.31–4.79).
ConclusionLifestyle and social and economic disadvantages are associated with all-cause and CVD mortality. The risk of mortality increases as the number of social and economic disadvantages and unhealthy lifestyles increases.

研究目的：本研究旨在以美国成年人群的大型代表性样本为研究对象，探究生活方式、社会经济因素与全因死亡及心血管疾病（CVD, Cardiovascular Disease）死亡之间的独立关联。此外，本研究还详细分析了生活方式与社会经济因素的联合暴露与死亡风险之间的关联。

研究方法：本研究纳入103314名拥有有效记录且符合死亡随访条件的参与者，相关数据来源于2000、2005、2010及2015年的美国全国健康访谈调查（NHIS, National Health Interview Survey），涵盖生活方式因素与社会经济劣势相关信息。研究基于体力活动、饮酒习惯、饮食状况与吸烟状态构建不健康生活方式评分。社会经济劣势通过受教育程度、股息收入、就业状况、家庭住房情况以及私人医疗保险获取情况进行评估。死亡数据信息由国家死亡索引（National Death Index）记录确定。

研究结果：与健康生活方式组相比，不健康生活方式组的全因死亡风险（风险比HR, Hazard Ratio=2.07；95%置信区间CI, Confidence Interval=1.97–2.19）与CVD死亡风险（HR=1.84；95%CI=1.68–2.02）均显著升高。相较于社会经济劣势较低的人群，社会经济劣势较高的人群其全因死亡风险（HR=2.44；95%CI=2.30–2.59）与CVD死亡风险（HR=2.44；95%CI=2.16–2.77）同样显著升高。在联合关联分析中，同时存在高社会经济劣势与不健康生活方式的参与者，其全因死亡风险（HR=4.06；95%CI=3.69–4.47）与CVD死亡风险（HR=3.98；95%CI=3.31–4.79）均进一步升高。

研究结论：生活方式与社会经济劣势均与全因死亡及CVD死亡风险相关。死亡风险随社会经济劣势因素与不健康生活方式因素的数量增加而逐步升高。