Socioeconomic status and psychological distress do not predict mortality risk in the island population of Vis, Croatia

Aims To investigate the association between socioeconomic status and psychological distress measured by the General health questionnaire (GHQ-30) with all-cause mortality, cardiovascular mortality and cancer mortality on the Croatian island of Vis. Methods This population-based cohort consisted of 1,025 subjects (426 men and 599 women), who were followed up for 18 years or a total of 5.8 million days. The causes of death were extracted from the Croatian National Institute of Public Health database. We calculated the adjusted hazard ratios, with subjective material status, years of schooling and a composite household material status used as estimates of socioeconomic status. Results There were 279 cases of death (27.2%). Socioeconomic status and psychological distress did not predict either the specific or the all-cause mortality risk. In addition, the interaction between socioeconomic variables and psychological distress also did not yield a significant hazard ratio in all three instances (all-cause, cardiovascular or tumour mortality). Conclusions These results confirm previous reports of the high level of social equality in the population of the island of Vis. Small and isolated communities may experience a lesser extent of social inequalities in health.