Premature Mortality and Accidental Death Among Young Adults in the United States: Association With the Social Determinants of Health

Background and objectives: This study explored the association between the social determinants of health (SDOH) and the likelihood of premature mortality and premature accidental mortality. Methods: Data from the National Longitudinal Survey of Adolescent to Adult Health (ADD Health) linked with records from the National Death Index (NDI) were used to classify deceased respondents by their cause of death. First, logistic regression examined the association between accidental death/premature mortality, individual characteristics, and SDOH. Second, a 2-stage model then analyzed the likelihood of having an accidental cause of death conditional on premature mortality. Results: Premature mortality odds were lower for female individuals (OR = 0.89), Black individuals (OR = 0.94), those who identify as Hispanic (OR = 0.56), college graduates (OR = 0.27), and married individuals (OR = 0.45). However, living in the South (OR = 1.19) and lower income (OR = 2.22) increased the odds. Accidental death odds were lower for female individuals (OR = 0.29), Black individuals (OR = 0.32), those who identify as Hispanic (OR = 0.87), and multiracial groups (OR = 0.06). College education (OR = 3.61) and lack of medical care (OR = 1.13) raised accidental death odds while marriage (OR = 0.20), lower income (OR = 0.12), and residing in the West or Midwest (OR = 0.13) decreased them. Conclusion: There was a significant association between the likelihood of accidental death and adverse SDOH, suggesting that they may serve as risk factors of premature accidental death.