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Whitehall II cohort study
In a civil service population, the association between relative socioeconomic position and all-cause mortality is substantially attenuated by adjustment for health behaviours
  1. Shah Ebrahim
  1. London School of Hygiene & Tropical Medicine London, UK
  1. Correspondence to Shah Ebrahim
    Department of Epidemiology & Population Health, Keppel Street, London WC1E 7HT, UK; shah.ebrahim{at}

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Social inequalities in all-cause and coronary heart disease mortality are well documented and are partly explained by common health behaviours – smoking, alcohol consumption, diet and physical inactivity. In this study, long-term changes in these behaviours are taken into account to see whether more variation in mortality can be explained.


Whitehall II – a large cohort of British civil servants – collected repeated data on health behaviours over 24 years in 9590 men and women. Socioeconomic position (SEP) at baseline was grouped into high, intermediate and low. Cox regression models of mortality by SEP were calculated, including health behaviours as time-dependent covariates and age and sex as potential confounders. Deaths were classified into four groups: all-cause, cancer, cardiovascular (CVD) and non-cancer, non-CVD. The per cent reductions in the HR attributable to health behaviours, individually and together, were presented as the main findings.


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  • Competing interests None.