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Daniel Ullmann, DSc(Med), MPH; Roland L. Phillipst, MD, DrPH; W. Lawrence Beeson, MSPH; Houston G. Dewey, PhD, MPH; Burton N. Brin, MPH; Jan W. Kuzma, PhD; Chacko P. Mathews, MD, MPH; Albert E. Hirst, MD

JAMA. 1991;265(18):2352-2359.

Abstract
We compare the mortality experience of medical school graduates from Loma Linda University (LLU [n = 4342]) and the University of Southern California (USC [n = 2832]) with each other and with that of contemporaneous, white, American men. When compared with US white men from the general population, both USC and LLU graduates had below expected deaths for all causes (USC, standardized mortality ratio [SMR] = 76; LLU, SMR = 56), although deaths due to cerebrovascular disease, airplane accidents, and suicides were elevated for USC (SMRs = 132,360, and 218, respectively). The LLU graduates had a risk similar to that of the USC graduates for fatal cancer, with a mortality ratio (MR) of 0.92 (95% confidence interval, 0.67 to 1.26); but half the risk of fatal atherosclerotic disease, with MRs of 0.58 (0.46 to 0.73) and 0.66 (0.43 to 0.99) for coronary and cerebrovascular disease, respectively; and three times the risk of fatal airplane accidents. The overall mortality rate of LLU physicians was only 75% as high as that of the USC physicians and only 56% as high as that of the US male population at large. We attribute this reduced mortality mainly to the low cardiovascular mortality rates, which may be accounted for by the life-style of the substantial proportion of Seventh-day Adventists among LLU graduates.

(JAMA. 1991;265:2352-2359)

Author Affiliations
From the Departments of Preventive Medicine and Medicine, Division of Endocrinology, Diabetes, and Clinical Nutrition, School of Medicine, Oregon Health Sciences University, Portland (Dr Ullmann); Departments of Preventive Medicine (Dr Phillips and Mr Beeson) and Pathology (Dr Hirst), School of Medicine, and Departments of Epidemiology and Biostatistics (Dr Kuzma) and Environmental Health (Mr Brin), School of Public Health, Loma Linda (Calif) University; Departments of Preventive Medicine (Dr Phillips) and Pathology (Dr Hirst), School of Medicine, University of Southern California, Los Angeles; Department of Epidemiology, Armed Forces Medical Intelligence Center, Department of Defense, Fort Detrick, Md (Dr Dewey): and Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick (Dr Mathews).

Footnotes
Dr Phillips died March 8,1987.

Presented in part (Circulation. 1989;80:11-59) at the Annual Scientific Sessions of the American Heart Association, New Orleans, La, November 12,1989.

Reprint requests to Division of Epidemiology and Biostatistics, Department of Preventive Medicine, L-352, Oregon Health Sciences University, 3181 SW Sam Jackson Park Rd, Portland, OR 97201-3098 (Dr Ullmann).

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