National Trends in Educational Differentials in Mortality

Abstract

The authors examined national changes in socioeconomic differentials in mortality for middle-aged and older white men and women in the United States with the use of 1960 data from the Matched Records Study and 1971-1984 data from the first National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Follow-up Study (NHEFS). In 1960, there was little difference in mortality by educational level among middle-aged and older men. Since 1960, death rates among men declined more rapidly for the more educated than the less educated, which resulted in substantial educational differentials in mortality in 1971-1984. In contrast, among women, death rates declined at about the same rate regardless of educational attainment, so that a strong inverse relation between education and mortality in 1960 remained about the same magnitude during 1971-1984. Trends in educational differentials for heart disease mortality are responsible for much of the change for all causes of death. Relative risk estimates based on the NHEFS indicate that after taking into account selected baseline risk factors the least educated are still at substantially elevated risk of death from heart disease, ranging from a relative risk of 1.38 for men aged 65-74 years at baseline to 2.27 for men aged 45-64 years. Reasons for the observed educational differentials and their changes over time are not easily explained and are likely to be multifactorial.

How is mortality affected by money, marriage, and stress?

“…This was attributed to the lower levels of income and wealth, and greater experience of poverty, within the black population. Feldman et al (1989) and Lahelma and Valkonen (1990) measured socioeconomic status by education, and once again observed an inverse relation with mortality. However, where comparisons are possible, income or wealth appear to be more powerful predictors of mortality risk (see Duleep, 1986, andMenchik, 1993).…”

Reconstruction of populations by age, sex and level of educational attainment for 120 countries for 1970-2000

“…Demographers are aware that mortality rates differ substantially among different socio-economic groups in the population (Kitagawa and Hauser 1973;Preston et al 1981;Pamuk 1985;Alachkar and Serow 1988;Duleep 1989;Feldman et al 1989;Elo and Preston 1996;Rogot et al 1992;Pappas et al 1993;Huisman et al 2004). Since a more detailed, direct measurement of these differentials can best be conducted in countries where there is a population register, much of the empirical analysis in this field tends to come from the Nordic countries.…”

Differences in Cancer Incidence, Mortality, and Survival between African Americans and Whites

“…From 1973 to 1991, there were significant declines in cervical cancer incidence among women of both races, oropharyngeal cancer mortality among whites, and bladder cancer mortality among both whites and African Americans. This report highlights selected cancer sites and briefly considers some of the potential risk factors investigated to explain differences in incidence and mortality among African Americans and whites. More detailed discussions of risk factors such as socioeconomic status (4)(5)(6)(7)(8)(9)(10)(11) can be found elsewhere.…”