David A. Alter, MD, PhD; SESAMI Study Group
Potential Financial Conflicts of Interest: None disclosed.
Alter DA, SESAMI Study Group. Socioeconomic Status and Mortality. Ann Intern Med. 2006;144:782. doi: 10.7326/0003-4819-144-10-200605160-00018
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Published: Ann Intern Med. 2006;144(10):782.
We appreciate the comments of Drs. Shishehbor and Litaker. We agree that socioeconomic status is a multidimensional construct of which income serves as only 1 of many social measures. Although such limitations were acknowledged in our paper, our study did adjust for individual education, employment status, ethnicity, and social support. Adjustment for such variables partially accounted for some of the heterogeneous features of socioeconomic status. Furthermore, the inclusion of more elaborative social measures, although intriguing, would not have mitigated the importance of exploring the causal pathway factors that mediate income–mortality associations—associations that have been consistently observed in the literature and require explanation (1).
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