The contribution of behavioural and metabolic risk factors to socioeconomic inequalities in mortality: the Italian Longitudinal Study.

The aim of this study was to assess social inequalities in overall mortality in a representative sample of the Italian population, and to evaluate the contribution of behavioural and metabolic risk (BMF) factors to these inequalities. 85,308 participants aged 25-74 years from the Italian Longitudinal Study were included in the study population and followed up for mortality (1999-2012). Level of education was used as a proxy for socioeconomic status. The contribution of BMF was estimated assessing the attenuation of the risk by education produced by the inclusion of BMF in regression model. Men with the lowest education had 62% and women had 57% greater risk of dying than those with the highest education. Among men, adjustment for BMF produced an attenuation of the mortality risk between extreme classes of education by 22%, while among women the risk attenuation was 7%. Large educational differences in mortality were observed for both men and women. BMF reduced by approximately 20% differences in mortality relative risk between extreme classes of education in men. In contrast, a very low contribution was observed in women