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Educational expansion and inequalities in mortality — A fixed-effects analysis using longitudinal data from 18 European populations
Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).ORCID iD: 0000-0002-7156-3260
Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).ORCID iD: 0000-0001-7795-3713
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2017 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 12, no 8, article id e0182526Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of this paper is to empirically evaluate whether widening educational inequalities in mortality are related to the substantive shifts that have occurred in the educational distribution.Materials and methods: Data on education and mortality from 18 European populations across several decades were collected and harmonized as part of the Demetriq project. Using a fixed-effects approach to account for time trends and national variation in mortality, we formally test whether the magnitude of relative inequalities in mortality by education is associated with the gender and age-group specific proportion of high and low educated respectively.Results: The results suggest that in populations with larger proportions of high educated and smaller proportions of low educated, the excess mortality among intermediate and low educated is larger, all other things being equal.Conclusion: We conclude that the widening educational inequalities in mortality being observed in recent decades may in part be attributed to educational expansion.

Place, publisher, year, edition, pages
2017. Vol. 12, no 8, article id e0182526
National Category
Public Health, Global Health and Social Medicine Sociology
Research subject
Sociology; Public Health Sciences
Identifiers
URN: urn:nbn:se:su:diva-146158DOI: 10.1371/journal.pone.0182526ISI: 000408355800027OAI: oai:DiVA.org:su-146158DiVA, id: diva2:1135727
Funder
EU, FP7, Seventh Framework Programme, 278511Available from: 2017-08-24 Created: 2017-08-24 Last updated: 2025-02-21Bibliographically approved
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
Keywords
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: 2022-02-28Bibliographically approved

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Östergren, OlofLundberg, OlleMartikainen, Pekka

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