PMID: 9447630Feb 3, 1998Paper

Does psychological distress contribute to racial and socioeconomic disparities in mortality?

Social Science & Medicine
K Fiscella, P Franks

Abstract

Being black or poor are powerful predictors of mortality. Although psychological distress has been proposed as mediating the effects of race and socioeconomic status on mortality, this hypothesis has not been previously directly tested. We used data from the National Health and Nutrition Examination I (NHANES I), a nationally representative sample from the U.S, and the NHANES I Epidemiological Follow-up Survey (NHEFS) of subsequent mortality to test this hypothesis. Both black race and lower family income were associated with significantly higher psychological distress as measured at the time of the initial survey by reports of hopelessness, depression, and life dissatisfaction. Black race and low income in addition to each of the measures of psychological distress were associated with higher mortality at follow-up. In a series of Cox proportional hazards models that controlled for the effects of age and gender, additional adjustment for hopelessness, depression, or life dissatisfaction had little effect on the relationship between either African American race or family income and subsequent all-cause mortality. We conclude that the effects of both race and income on mortality are largely independent of psychological distress. ...Continue Reading

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Citations

Sep 24, 2008·Archives of Internal Medicine·Kevin Fiscella, Ronald M Epstein
Apr 23, 2005·Administration and Policy in Mental Health·Marilyn C Daley
Sep 27, 2005·Behavior Genetics·Wendy Johnson, Robert F Krueger
Dec 22, 2010·Journal of General Internal Medicine·O Kenrik DuruCarol M Mangione
Apr 17, 2004·Social Science & Medicine·Ross BarnettRobin Kearns
May 26, 2005·Social Science & Medicine·Peter MuennigMarthe R Gold
Feb 15, 2012·Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association·Michael W KrausTeh-Way David Chen
Feb 22, 2000·Annals of the New York Academy of Sciences·A BaumA M Yali
Feb 22, 2000·Annals of the New York Academy of Sciences·L C Gallo, K A Matthews
Mar 21, 2009·BMC Public Health·Maili Malin, Mika Gissler
Sep 28, 2006·International Journal for Equity in Health·Mark DanielKerin O'Dea
Apr 4, 2002·Environmental Health Perspectives·Russ Lopez
Oct 28, 2004·Annals of Family Medicine·Kevin Fiscella, Peter Franks
Jun 18, 2011·American Journal of Public Health·Sandro GaleaAdam Karpati
Jul 18, 2003·Annals of Behavioral Medicine : a Publication of the Society of Behavioral Medicine·Miyong T KimMary Roary
Dec 5, 2009·The American Journal of Medicine·Azad A KabirGerald S Berenson
Aug 17, 2002·Biological Psychiatry·Richard SchulzBruce L Rollman
Jul 11, 2006·Environmental Research·Rachel Morello-Frosch, Russ Lopez
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Oct 31, 2015·The Journal of Clinical Hypertension·Soohyun NamCarl Latkin
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Feb 2, 2006·Psychosomatic Medicine·Rebecca C ThurstonLisa F Berkman
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Nov 30, 1999·Annals of Internal Medicine·K Fiscella, P Franks
Jul 1, 2004·Psychological Science in the Public Interest : a Journal of the American Psychological Society·Ed Diener, Martin E P Seligman
Mar 14, 2018·Community Mental Health Journal·Huiping ZhangMingming Cheng

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