Premature mortality linked to race and socioeconomic deprivation in Washington

Closeup of Pablo Monsivais
Pablo Monsivais

SPOKANE, Wash. – Researchers at Washington State University Elson S. Floyd College of Medicine released a new report in Health & Place showing that premature mortality—death occurring before the age of 65—is three to eight times more likely among non‑whites from low‑income neighborhoods compared to more‑affluent whites in Washington.

The study, which examined all registered deaths in Washington from 2011–2015, found that the combination of race and neighborhood socioeconomic disadvantage exponentially increased the incidence of premature death.

While socioeconomic deprivation alone was a predictor of premature mortality in the largely white (92 percent) population of Washington decedents—premature deaths were about one and a half times more common in whites from more deprived areas than affluent areas—area deprivation was associated with more extreme likelihood of premature death for some racial categories.

Premature deaths among American Indian/Alaska Native, black and multi‑racial decedents from deprived areas were about three times more common than for more‑affluent whites. Deaths among Native Hawaiian/Pacific Islanders from deprived areas were nearly eight times as likely to be premature compared to deaths of more‑affluent whites. The one exception was Asian decedents who showed only a modest association between premature death and deprivation.

“Many studies have confirmed that white individuals living in affluent areas live longer lives and that premature death is more common in low‑income communities and communities of color, but less is known about if and how the intersection of race and socioeconomic deprivation impact health,” said Pablo Monsivais, associate professor in the Department of Nutrition and Exercise Physiology. “What we found when we analyzed both of these factors together is that it creates an eye‑popping increase in premature mortality.”

Monsivais and his team analyzed the data, supplied by the Washington State Department of Health, of more than 240,000 deaths that occurred from 2011–2015 for which they could obtain the last residential address for individuals at the time of their death. Using those addresses, they classified each decedent’s exposure to socioeconomic deprivation, as well as race, education, gender and other characteristics. Nearly one quarter (23.5 percent) of all deaths were premature. Cancer and heart disease were the leading causes of premature death.

The research was funded in part by the Health Equity Research Center, an interdisciplinary network of WSU faculty, staff, and students working to understand the factors that promote health resilience and decrease health risks associated with poverty, discrimination, and poor access to healthcare.

Though further research is needed to identify the environmental and policy-related factors that may contribute to premature death among these populations, Monsivais and his team note that poor housing conditions, absence of healthy living facilities, lack of access to health and social services, and stress from financial insecurity likely play a part in the premature death disparities.

“There’s still a lot of work to be done to fully understand the ‘why’ and ‘how’ behind these disparities, but now that we understand just how extensively racial inequalities in mortality are amplified by social and environmental challenges in low-socioeconomic areas, our team can dig deeper into these challenges and work toward identifying solutions for our communities,” said Monsivais.

The complete report is available online.

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