Trying Times: Waiting to Learn What Is Happening Now in American Premature Mortality

Over time, the effect of social and health policies across populations, including multiple racial/ethnic groups, can be especially challenging to track. Long latency periods between shifts in health care delivery, broad environmental exposures, and outcomes including mortality often limit the inferences one can draw from what become complex observational studies of health.In this issue of AJPH, Roy et al. (p. 530) present mortality data after 32 years of follow-up in the Coronary Artery Risk Development in Young Adults (CARDIA) study to offer insights in health trajectories relative to race/ethnicity, education, and common chronic health conditions. Overall, 5115 participants enrolled in 1985 to 1986 as young adults (aged 18-30 years; mean age = 25 years) in four diverse American locations: Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; and Oakland, California. On the basis ofyears ofpotential life lost, the primary findings identified important differences in mortality rates and causes of mortality, by race/ethnicity and education, and supported education as an explanatory variable for racial/ ethnic differences in mortality.