Educational inequalities in mortality over four decades in Norway: prospective study of middle aged men and women followed for cause specific mortality, 1960-2000

Strand, Bjørn Heine; Grøholt, Else‐Karin; Steingrímsdóttir, Ólöf Anna; Blakely, Tony; Graff-Iversen, Sidsel; Næss, Øyvind

doi:10.1136/bmj.c654

Cited by 123 publications

(114 citation statements)

References 22 publications

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“…In previous studies, increasing mortality inequalities are shown to be driven by an increasing gap in cardiovascular disease mortality (Mackenbach et al, 2003) and other smoking-related causes of death such as lung cancer and lower respiratory diseases (Strand et al, 2010). In Finland, the increase is mainly explained by a growing disparity in alcohol-related deaths, as well as many cancers, between high-and low-income groups (Tarkiainen, Martikainen, Laaksonen, and Valkonen, 2012).…”

Section: Related Literaturementioning

confidence: 96%

“…Increasing differences in life expectancy between socio-economic groups have recently been observed in a number of high-income countries; for example in the US (Montez and Zajacova, 2013); the UK (Marmot and Brunner, 2005), and in Norway (Steingrimsdottir et al, 2012;Strand et al, 2010). For Sweden, the difference in mortality risk between educational levels has widened during the last decades (Shkolnikov et al, 2012; The National Board of Health and Welfare [Socialstyrelsen], 2013).…”

Section: Related Literaturementioning

confidence: 99%

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Trends in Life Expectancy by Income and the Role of Specific Causes of Death

et al. 2017

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This study explores how life expectancy at age 35 has evolved across the income distribution in Sweden over time. We examine individual income for men 1970–2007 and family income for both men and women 1980–2007. During this period, income inequality increased in most western countries, but especially so in Sweden. Drawing on a large sample of the Swedish population, our results show that the gap in life expectancy between the richest and poorest fifths of the income distribution also increased. This was the case both for individual and family income. The increase was larger for men than for women, but the only group with stagnant life expectancy at age 35 was women in the lowest income quintile group. Between 1986 and 2007, the difference between the lowest and highest family income quintiles increased by about one year for women and by almost two years for men. The causes of death that most significantly contributed to the increased disparities among women were circulatory and respiratory diseases. For men, circulatory disease mortality alone caused most of the increased disparities.

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Section: Related Literaturementioning

confidence: 96%

Section: Related Literaturementioning

confidence: 99%

Trends in Life Expectancy by Income and the Role of Specific Causes of Death

et al. 2017

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“…Causespecific mortality rates might provide some clues. In middle aged populations, and especially among men, cardiovascular mortality has been the main cause of increasing socio-economic-based inequalities in mortality [46,47]. A frequently suggested explanation has been the tobacco epidemic [45,48,49].…”

Section: Explanation and Interpretation Of Our Resultsmentioning

confidence: 99%

Trends in remaining life expectancy at retirement age (65 years) by educational level in Norway 1961-2009

Moe¹,

Steingrímsdóttir²,

Strand³

et al. 2012

Nor J Epidemiol

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Background: Over the last half a century education based inequalities in life expectancy have increased in younger populations, but our knowledge of long-term trends in old-age life expectancy differentials is sparse. We investigated the trends in remaining life expectancy at age 65 (e 65 ) according to education in Norway for the period 1961-2009. Methods: This was a register-based population study including all Norwegian residents aged 65 years and older. Individual-level data were provided by the Central Population Registry and the National Educational Database. We classified education into higher and lower education and constructed one life table for each calendar year, sex, and educational group. We tested for trends using weighted least square regression models.Results: e 65 increased over the observation period for all educational groups, but the difference in e 65 increased by 0.060 life years per calendar year in men and 0.025 life years per calendar year in women (P < 0.001). The increase in e 65 in less-educated men slowed in the 1980s and 1990s, whereas e 65 in less-educated women decelerated from the 1980s, and significantly so from 2001 (P = 0.029). Conclusions: Educational-based inequalities in e 65 increased over the last half century. The increase seems to be temporal in men and might be ongoing in women. Increasing inequalities in e 65 challenge public health policy and will become increasingly important in the ageing societies of the future. In addition, they imply increasing deviation from the overall life expectancy of the population, which forms the basis of the recently implemented adjustment of pension levels according to life expectancy. Divergent trends in e 65 according to educational level may also have implications for future demographic projections.

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“…Such data sources have been used to investigate the effect of education on lifetime outcomes, including analyzing the effects of schooling on morbidity and lifespans. Some of the largest available studies, including those with full population coverage and a relatively broad set of control variables, suggest a strong positive association of education with longevity (Strand et al 2010;Remes et al 2010;Brønnum-Hansen et al 2004). …”

Section: Effects Of Education On Health and Mortalitymentioning

confidence: 99%