Approved Research

Joint effects of socioeconomic status and individual risk factors on all cause and cause-specific morbidity and mortality

Lay summary

Individual risk factors such as alcohol use, smoking, low physical activity, and high body mass index (BMI) are associated with poor health. In the United Kingdom, these risk factors accounted for a large proportion of the overall disease burden in 2019, with alcohol use accounting for about 5%, smoking for about 19%, low physical activity for about 2%, and high BMI for about 9%; and these proportions have been increasing over the past 30 years, particularly for alcohol use and high BMI. However, the health burden related to each of the individual risk factors appears to differ by socioeconomic status, defined as an individual's social and economic position within a society and generally determined by their income, education, and occupation. It is important to understand the causes of these socioeconomic inequalities, beyond the mere level of risk factor exposure (also known as differential exposure), as differences, for example, in alcohol use alone do not fully explain the observed health inequalities in alcohol-related health outcomes. Differential vulnerability, which means that some groups, such as individuals with low socioeconomic status, are more vulnerable to the harmful effects of some individual risk factors such as alcohol use or smoking, is another potential explanation. To better understand differential vulnerability, our project will use data from the UK Biobank and advanced statistical models to analyze the relationship between exposure to individual risk factors and disease outcomes on the individual level. This study will help us to better understand the differences observed in the proportion of overall disease burden accounted for by certain individual risk factors across socioeconomic groups. The results of our study will inform public health prevention and intervention strategies by identifying the individual risk factors for which a reduction in the level of exposure might benefit groups of the population that experience the highest health burden. Our project is estimated to last three years.