Table 2.
Natural effect estimates pooled and by cohorta separately for men and women, displaying total, natural direct and indirect effects for socio-economic indicators of socio-economic position and education, and joint mediation by smoking, alcohol consumption, Western dietary pattern, physical activity, body mass index, coronary artery disease, diabetes and hypertension
| Socio-economic positionb | |||||||
|---|---|---|---|---|---|---|---|
| Cohort | HR | HR | HR | HR | HR | HR | HR |
| (95% CI) | (95% CI) | (95% CI) | (95% CI) | (95% CI) | (95% CI) | (95% CI) | |
| TEL | TEH | NDEH | NDEL | NIEH | NIEL | PM | |
| Pooledw | 1.06 | 0.94 | 0.92 | 1.09 | 1.03 | 0.97 | –0.46 |
| (1.05, 1.07) | (0.93, 0.95) | (0.91, 0.93) | (1.08, 1.10) | (1.01, 1.04) | (0.96, 0.99) | (–0.73, –0.23) | |
| EPIC-ITw | 1.08 | 0.93 | 0.90 | 1.11 | 1.03 | 0.97 | –0.38 |
| (1.07, 1.08) | (0.92, 0.93) | (0.89, 0.92) | (1.09, 1.12) | (1.01, 1.04) | (0.96, 0.99) | (–0.59, –0.17) | |
| EPIPORTOw | 2.05 | 0.49 | 0.71 | 1.40 | 0.69 | 1.50 | 0.53 |
| (1.92, 2.23) | (0.45, 0.53) | (0.67, 0.75) | (1.34, 1.48) | (0.65, 0.72) | (1.40, 1.54) | (0.48, 0.58) | |
| GAZELw | 0.84 | 1.18 | 1.11 | 0.90 | 1.07 | 0.94 | 0.36 |
| (0.78, 0.91) | (1.09, 1.28) | (1.06, 1.17) | (0.85, 0.95) | (1.001, 1.13) | (0.88, 0.99) | (0.0078, 0.60) | |
| WHITEHALLw | 1.06 | 0.94 | 0.96 | 1.04 | 0.98 | 1.02 | 0.29 |
| (1.04, 1.08) | (0.92, 0.96) | (0.92, 0.99) | (1.0, 1.08) | (0.94, 1.03) | (0.98, 1.06) | (–0.46, 0.97) | |
| Pooledm | 1.30 | 0.80 | 0.83 | 1.22 | 0.97 | 1.04 | 0.17 |
| (1.24, 1.30) | (0.78, 0.82) | (0.81, 0.84) | (1.20, 1.24) | (0.95, 0.99) | (1.02, 1.10) | (0.088, 0.24) | |
| CoLausm | 1.31 | 0.77 | 0.81 | 1.24 | 0.96 | 1.06 | 0.13 |
| (1.08, 1.54) | (0.64, 0.92) | (0.74, 0.89) | (1.12, 1.36) | (0.96, 1.008) | (0.95, 1.17) | (–0.43, 0.40) | |
| EPIC-ITm | 1.21 | 0.83 | 0.87 | 1.15 | 0.95 | 1.06 | 0.30 |
| (1.21, 1.23) | (0.82, 0.83) | (0.85, 0.89) | (1.13, 1.17) | (0.93, 0.97) | (1.03, 1.08) | (0.18, 0.40) | |
| EPIPORTOm | 1.10 | 0.95 | 0.97 | 1.03 | 0.98 | 1.02 | 0.28 |
| (1.01, 1.10) | (0.91, 1.00) | (0.91, 1.05) | (0.95, 1.10) | (0.90, 1.06) | (0.94, 1.11) | (–2.9, 2.80) | |
| GAZELm | 1.31 | 0.77 | 0.73 | 1.40 | 1.05 | 0.95 | 1.39 |
| (1.24, 1.38) | (0.73, 0.81) | (0.71, 0.75) | (1.33, 1.42) | (1.01, 1.10) | (0.91, 0.99) | (–0.83, 2.40) | |
| WHITEHALLm | 1.54 | 0.65 | 0.75 | 1.33 | 0.86 | 1.20 | 0.34 |
| (1.40, 1.70) | (0.60, 0.71) | (0.71, 0.79) | (1.26, 1.39) | (0.79, 0.93) | (1.07, 1.30) | (0.19, 0.46) | |
|
| |||||||
| Educationc | |||||||
|
| |||||||
| TEL | TEH | NDEH | NDEL | NIEH | NIEL | PM | |
|
| |||||||
| Pooledw | 1.18 | 0.85 | 0.90 | 1.11 | 0.95 | 1.06 | 0.34 |
| (1.16, 1.19) | (0.84, 0.86) | (0.89, 0.91) | (1.10, 1.12) | (0.94, 0.96) | (1.04, 1.07) | (0.29, 0.38) | |
| EPIC-ITw | 1.10 | 0.96 | 0.98 | 1.02 | 0.97 | 1.03 | 1.39 |
| (0.98, 1.11) | (0.88, 1.02) | (0.95, 1.02) | (0.98, 1.06) | (0.93, 1.02) | (0.98, 1.08) | (–0.83, 2.4) | |
| EPIPORTOw | 2.75 | 0.36 | 0.58 | 1.71 | 0.62 | 1.61 | 0.47 |
| (2.07, 3.74) | (0.26, 0.49) | (0.49, 0.68) | (1.48, 2.00) | (0.53, 0.72) | (1.39, 1.89) | (0.43, 0.50) | |
| GAZELw | 2.67 | 0.51 | 0.55 | 1.65 | 0.93 | 1.62 | 0.10 |
| (2.01, 3.64) | (0.41, 0.62) | (0.49, 0.60) | (1.43, 1.94) | (0.82, 1.04) | (1.39, 1.90) | (–0.8, 0.23 | |
| WHITEHALLw | 1.03 | 0.97 | 1.00 | 0.99 | 0.96 | 1.04 | 0.10 |
| (0.96, 1.13) | (0.89, 1.1) | (0.96, 1.06) | (0.94, 1.05) | (0.90, 1.03) | (0.97, 1.10) | (–0.8, 0.23) | |
| MCCSw | 1.19 | 0.84 | 0.91 | 1.10 | 0.92 | 1.10 | 0.45 |
| (1.15, 1.22) | (0.81, 0.87) | (0.89, 0.93) | (1.08, 1.12) | (0.90, 0.95) | (1.05, 1.11) | (0.34, 0.51) | |
| E3Nw | 1.16 | 0.87 | 0.92 | 1.10 | 0.94 | 1.06 | 0.42 |
| (1.14, 1.17) | (0.86, 0.88) | (0.91, 0.93) | (1.08, 1.10) | (0.93, 0.95) | (1.05, 1.07) | (0.36, 0.47) | |
| Pooledm | 1.38 | 0.71 | 0.82 | 1.22 | 0.89 | 1.13 | 0.38 |
| (1.35, 1.40) | (0.70, 0.74) | (0.81, 0.83) | (1.21, 1.24) | (0.87, 0.90) | (1.11, 1.15) | (0.35, 0.42) | |
| CoLausm | 1.80 | 0.58 | 0.66 | 1.53 | 0.88 | 1.17 | 0.26 |
| (1.50, 2.23) | (0.47, 0.70) | (0.59, 0.73) | (1.39, 1.71) | (0.79, 0.98) | (1.05, 1.32) | (0.14, 0.36) | |
| EPIC-ITm | 1.72 | 0.61 | 0.67 | 1.52 | 0.90 | 1.13 | 0.20 |
| (1.44, 2.13) | (0.55, 0.66) | (0.64, 0.71) | (1.38, 1.69) | (0.85, 0.95) | (1.02, 1.27) | (0.11, 0.28) | |
| Education c | |||||||
|---|---|---|---|---|---|---|---|
| TEL | TEH | NDEH | NDEL | NIEH | NIEL | PM | |
| EPIPORTOm | 2.20 | 0.46 | 0.52 | 1.93 | 0.88 | 1.14 | 0.15 |
| (1.79, 2.77) | (0.37, 0.56) | (0.43, 0.58) | (1.72, 2.19) | (0.77, 1.01) | (0.98, 1.33) | (–0.09, 0.29) | |
| GAZELm | 2.24 | 0.53 | 0.66 | 1.95 | 0.81 | 1.15 | 0.16 |
| (1.84, 2.80) | (0.50, 0.57) | (0.63, 0.68) | (1.75, 2.20) | (0.78, 0.85) | (0.99, 1.34) | –0.012, 0.30) | |
| WHITEHALLm | 1.10 | 0.91 | 0.94 | 1.06 | 0.96 | 1.04 | 0.40 |
| (1.08, 1.12) | (0.88, 0.93) | (0.92, 0.97) | (1.03, 1.09) | (0.93, 0.99) | (1.01, 1.07) | (0.13, 0.67) | |
| MCCSm | 1.34 | 0.77 | 0.83 | 1.17 | 0.93 | 1.15 | 0.47 |
| (1.31, 1.37) | (0.75, 0.79) | (0.82, 0.85) | (1.15, 1.19) | (0.91, 0.95) | (1.12, 1.17) | (0.40, 0.52) | |
Pooled models were adjusted for age, marital status and cohort status, and cohort-specific models were adjusted for age and marital status.
n = 32 067 for women and n = 31 089 for men.
n = 131 020 for women and n = 48 033 for men.
HR, hazard ratio; TEL, total effect where socio-economic indicators are set to lower status; TEH, total effect where socio-economic indicators are set to a higher status; NDEL, natural direct effect where socio-economic indicators are set to a lower status; NDEH, natural direct effect where socio-economic indicators are set to a higher status; NIEL, natural indirect effect where socio-economic indicators are set to lower status through all mediators; NIEH, natural indirect effect where socio-economic indicators are set to higher status through all mediators; PM, the proportion of the effect where socio-economic indicators are set to higher that is mediated through all mediators; m, men; w, women.