Educational Differences in U.S. Adult Mortality

Abstract

We use hierarchical cross-classified random-effects models to simultaneously measure age, period, and cohort patterns of mortality risk between 1986 and 2006 for non-Hispanic white and non-Hispanic black men and women with less than a high school education, a high school education, and more than a high school education. We examine all-cause mortality risk and mortality risk from heart disease, lung cancer, and unpreventable cancers. Findings reveal that temporal reductions in black and white men’s and women’s mortality rates were driven entirely by cohort changes in mortality. Findings also demonstrate that disparate cohort effects between education groups widened the education gap in all-cause mortality risk and mortality risk from heart disease and lung cancer across this time period. Educational disparities in mortality risk from unpreventable cancers, however, did not change. This research uncovers widening educational differences in adult mortality and demonstrates that a cohort perspective provides valuable insights for understanding recent temporal changes in U.S. mortality risk.

The Emerging Theoretical Framework of Life Course Health Development

“…Untangling age, period, and cohort effects and understanding the cumulative impact of experience on socially and institutionally constructed life pathways form the basis of life course sociology. For example, the experience of low socioeconomic status, discrimination, and racial segregation may have different effects on health for different cohorts (i.e., groups born at different times), based on prevailing (period effects), compensatory, and mediating factors such as the availability of healthcare or the impact of different social policies (Chen et al 2010;Masters et al 2012).…”

Educational expansion and the education gradient in health: A hierarchical age-period-cohort analysis

“…There are different reasons to assume converging trajectories with age. First, mortality selection might be an important explanation (Dupre, 2007;Masters et al, 2012;Ross & Wu, 1996). Because of the higher rates of mortality at younger ages among the less educated, selection leads to a decrease in heterogeneity at older ages.…”

Potential Reduction in Mortality Associated with the Shifts of Population Educational Structures in the Czech Republic

“…However, infant and child mortality fell faster during the twentieth century and also childhood health dramatically improved. Thus, the association between early-life conditions and adult mortality has diminished across cohorts at the aggregate level [12]. Consequently, personal behaviors (diet, smoking, alcoholism, exercise) and the knowledge and the use of health technologies afect adult mortality risk more than early life factors [12].…”

“…The study of Becket [32] conirms the convergence gradient with age and shows that the protective efect of higher education declines with age because higher educated groups only postpone morbidity toward older age. On the other hand, Masters et al [12] demonstrate the use of age-period-cohort modeling that educational gap in mortality grows across birth cohorts but not across time periods. Disparities in mortality by education are wider among men than among women.…”

“…Since then, many studies have pointed out the diferences in mortality by socioeconomic status [1,[3][4][5][6][7][8]. Moreover, time trends in socioeconomic inequalities in mortality have shown a widening of the gap, in relative terms, in Europe as well as in North America [9][10][11][12]. Education, occupational status, and income are the most widely used indicators of socioeconomic status.…”