Citation

Elstad JI, Hofoss D, Dahl E. Nor. Epidemiol. 2007; 17(1): 37-42.

Copyright

(Copyright © 2007, Norsk Forening for Epidemiologi)

DOI

unavailable

PMID

unavailable

Abstract

This article analyses educational inequalities in mortality and examines the role of different causes of death for these differences. Data are constructed by linkages of Norwegian administrative registers. The analysed sample consists of practically all men and women living in Norway in 1993 and aged 25-66 years (N = 2.2 millions). Deaths 1994-2003, classified into 18 groups of causes, were analysed by age-adjusted logistic regression (outcome variable died/survived 1994-2003). Age-adjusted estimations of how many deaths could potentially be avoided if mortality risk for all educational levels had been equal to the risk among higher university educated (12% of the sample) were made. During 1994-2003, 104,000 of the sample died (men 5.8%, women 3.5%). Odds ratios (ORs) for all deaths increased for each descending level of education (ORs basic education versus higher university 2.6/2.2 for men/women). Educational differences were very large for substance abuse deaths and well above average for chronic lung disease and alcohol-related deaths. ORs were also clearly above average for lung cancer deaths (both sexes) and ischaemic heart disease deaths (only women). Educational differences were relatively small or insignificant for other cancer categories. Among women, no educational inequalities were found for colorectal cancer, suicide, breast cancer, and traffic accidents. If death risk in lower educational levels had been equal to the observed death risk in higher university education, 43% (men) and 39% (women) of the actually occurring deaths 1994-2003 would have been avoided. More than half of these potentially avoided deaths occurred among those with basic education (25% of the sample). Cardiovascular diseases represented 38% (men) and 35% (women) of this hypothetical potential for avoided deaths. Also lung cancer (12% both sexes) and chronic lung disease (6% men, 11% women) contributed strongly to the number of excess deaths.

FINDINGS are interesting in view of current discussions about strategies for reducing socioeconomic inequalities in health.

Language: no

Keywords

adult; human; suicide; female; male; ischemic heart disease; aged; cause of death; mortality; education; traffic accident; substance abuse; article; controlled study; breast cancer; cardiovascular disease; lung cancer; colorectal cancer; chronic lung disease