4.6 Article

Race, Flourishing, and All-Cause Mortality in the United States, 1995-2016

Journal

AMERICAN JOURNAL OF EPIDEMIOLOGY
Volume 190, Issue 9, Pages 1735-1743

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwab067

Keywords

flourishing; death; health disparities; race

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Race moderates the association between flourishing and all-cause mortality, with Black individuals showing higher mortality rates. However, Black individuals with higher levels of flourishing have similar mortality rates to Whites, indicating the potential for health-promotion efforts to reduce racial disparities in mortality rates.
We assessed whether race moderates the association between flourishing and all-cause mortality. We used panel data from the Midlife in the United States Study (MIDUS) (1995-2016; n = 2,851). Approximately 19% of White respondents and 23% of Black respondents in the baseline sample died over the course of the 21-year study period (n = 564). Cox proportional hazard models showed that Blacks had a higher mortality rate relative to Whites and higher levels of flourishing were associated with a lower mortality rate. Furthermore, a significant interaction between flourishing and race in predicting death was observed. Blacks with higher levels of flourishing had a mortality rate that was not significantly different from that of Whites. However, Blacks, but not Whites, with low flourishing scores had a higher mortality rate. As such, health-promotion efforts focused on enhancing flourishing among Black populations may reduce the Black-White gap in mortality rate.

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