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The contribution of alcohol consumption and smoking to educational inequalities in life expectancy among Swedish men and women during 1991–2008
Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
University of Helsinki, Finland.
Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
2017 (English)In: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objectives

To assess the level and changes in contribution of smoking and alcohol-related mortality to educational differences in life expectancy in Sweden.

Methods

We used register data on the Swedish population at ages 30–74 during 1991–2008. Cause of death was used to identify alcohol-related deaths, while smoking-related mortality was estimated using lung cancer mortality to indirectly assess the impact of smoking on all-cause mortality.

Results

Alcohol consumption and smoking contributed to educational differences in life expectancy. Alcohol-related mortality was higher among men and contributed substantially to inequalities among men and made a small (but increasing) contribution to inequalities among women. Smoking-related mortality decreased among men but increased among women, primarily among the low educated. At the end of the follow-up, smoking-related mortality were at similar levels among men and women. The widening gap in life expectancy among women could largely be attributed to smoking.

Conclusions

Smoking and alcohol consumption contribute to educational differences in life expectancy among men and women. The majority of the widening in the educational gap in mortality among women can be attributed to alcohol and smoking-related mortality.

Place, publisher, year, edition, pages
2017.
Keyword [en]
Mortality, Health inequalities, Alcohol, Smoking, Registers
National Category
Public Health, Global Health, Social Medicine and Epidemiology Sociology
Research subject
Sociology
Identifiers
URN: urn:nbn:se:su:diva-146139DOI: 10.1007/s00038-017-1029-7OAI: oai:DiVA.org:su-146139DiVA: diva2:1135605
Available from: 2017-08-23 Created: 2017-08-23 Last updated: 2017-09-07
In thesis
1. Understanding the Educational Gradient in Mortality
Open this publication in new window or tab >>Understanding the Educational Gradient in Mortality
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

There is a positive association between education and longevity. Individuals with a university degree tend to live longer than high school graduates who, in turn, live longer than those with compulsory education. These differences are neither larger nor smaller in Sweden than in other European countries, despite its ambitious welfare-state policies. Furthermore, educational differences in longevity are growing, especially among women.

In this thesis I look at the structural, individual and behavioral processes which generate and maintain the educational gradient in mortality. This is done by compiling theoretical insights and empirical research from a range of scientific disciplines. In doing so, this thesis aims to contribute to a more comprehensive understanding of the educational gradient in mortality.

Several factors contribute to the association between education and health. Social and biological processes initiated in early life influence both educational achievement and adult health. Education helps individuals become more effective as agents by fostering generic skills such as information-gathering and decision-making. This aspect of education, learned effectiveness, promotes control and health regardless of available resources and prevailing conditions. Education thus has a direct influence on health. Education also indirectly influences health by giving access to better occupational positions and higher incomes, as well as by promoting social capital and healthy habits.

The empirical section of the thesis consists of four separate quantitative studies using register data. Three of the studies use Swedish national register data while one uses register data from 18 European populations. The results indicate that widening income inequalities in mortality have contributed to a widening of educational inequalities in mortality, since education is a determinant of income. Both alcohol and smoking contribute to educational inequalities in longevity, but smoking has played an especially pronounced role in the widening of inequalities among women. Smoking represents a significant part of the explanation as to why women with low education have experienced smaller gains in life expectancy than the rest of the population. The results also indicate that the general trend towards more well-educated populations has contributed to the widening educational inequalities in mortality in Europe and that education is a stronger predictor of mortality among low income-earners than among the rest of the population.

Place, publisher, year, edition, pages
Stockholm: Department of Sociology, Stockholm University, 2017
Series
Health Equity Studies, ISSN 1651-5390 ; 23
Keyword
social inequalites in health, education, mortality, register data, Sweden, smoking, alcohol
National Category
Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Research subject
Sociology
Identifiers
urn:nbn:se:su:diva-146655 (URN)978-91-7649-889-7 (ISBN)978-91-7649-890-3 (ISBN)
Public defence
2017-10-27, hörsal 11, hus F, Universitetsvägen 10 F, Stockholm, 10:00 (English)
Opponent
Supervisors
Note

At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 4: Manuscript.

Available from: 2017-10-04 Created: 2017-09-04 Last updated: 2017-09-20Bibliographically approved

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