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American Journal of Public Health logoLink to American Journal of Public Health
. 1994 Jun;84(6):932–937. doi: 10.2105/ajph.84.6.932

The size of mortality differences associated with educational level in nine industrialized countries.

A E Kunst 1, J P Mackenbach 1
PMCID: PMC1614960  PMID: 8203689

Abstract

OBJECTIVES. This study addresses the question of whether inequalities in premature mortality related to educational level differ among countries. METHODS. Data on mortality by educational level were obtained from longitudinal studies from nine industrialized countries. The data referred to men between 35 and 64 years of age. The follow-up periods occurred between 1970 and 1982. The size of mortality differences associated with educational level was measured by means of two inequality indices, both based on Poisson regression analysis. RESULTS. Inequalities in mortality are relatively small in the Netherlands, Sweden, Denmark, and Norway and about two times as large in the United States, France, and Italy. Finland and England and Wales occupy intermediate positions. The large inequalities in mortality in the United States and France can be attributed in part to large inequalities in education in these countries. CONCLUSIONS. The international pattern found in this study was also observed in a comparison that used occupation as the socioeconomic indicator. Differences between countries in levels of inequality in mortality may be partially explained by the countries' different levels of egalitarian social and economic policies.

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Selected References

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  1. Doornbos G., Kromhout D. Educational level and mortality in a 32-year follow-up study of 18-year-old men in The Netherlands. Int J Epidemiol. 1990 Jun;19(2):374–379. doi: 10.1093/ije/19.2.374. [DOI] [PubMed] [Google Scholar]
  2. Kagamimori S., Iibuchi Y., Fox J. A comparison of socioeconomic differences in mortality between Japan and England and Wales. World Health Stat Q. 1983;36(2):119–128. [PubMed] [Google Scholar]
  3. Kunst A. E., Looman C. W., Mackenbach J. P. Socio-economic mortality differences in The Netherlands in 1950-1984: a regional study of cause-specific mortality. Soc Sci Med. 1990;31(2):141–152. doi: 10.1016/0277-9536(90)90055-w. [DOI] [PubMed] [Google Scholar]
  4. Lahelma E., Valkonen T. Health and social inequities in Finland and elsewhere. Soc Sci Med. 1990;31(3):257–265. doi: 10.1016/0277-9536(90)90272-t. [DOI] [PubMed] [Google Scholar]
  5. Leclerc A., Lert F., Goldberg M. Les inégalités sociales devant la mort en Grande-Bretagne et en France. Soc Sci Med. 1984;19(5):479–487. doi: 10.1016/0277-9536(84)90043-1. [DOI] [PubMed] [Google Scholar]
  6. Neumann G., Liedermann A. Mortalitat und Sozialschicht. Bundesgesundheitsblatt. 1981 May 29;24(11):173–181. [PubMed] [Google Scholar]
  7. Pamuk E. R. Social class inequality in mortality from 1921 to 1972 in England and Wales. Popul Stud (Camb) 1985 Mar;39(1):17–31. doi: 10.1080/0032472031000141256. [DOI] [PubMed] [Google Scholar]
  8. Pappas G., Queen S., Hadden W., Fisher G. The increasing disparity in mortality between socioeconomic groups in the United States, 1960 and 1986. N Engl J Med. 1993 Jul 8;329(2):103–109. doi: 10.1056/NEJM199307083290207. [DOI] [PubMed] [Google Scholar]
  9. Valkonen T. Problems in the measurement and international comparisons of socio-economic differences in mortality. Soc Sci Med. 1993 Feb;36(4):409–418. doi: 10.1016/0277-9536(93)90403-q. [DOI] [PubMed] [Google Scholar]
  10. Vågerö D., Lundberg O. Health inequalities in Britain and Sweden. Lancet. 1989 Jul 1;2(8653):35–36. doi: 10.1016/s0140-6736(89)90266-3. [DOI] [PubMed] [Google Scholar]
  11. Wagstaff A., Paci P., van Doorslaer E. On the measurement of inequalities in health. Soc Sci Med. 1991;33(5):545–557. doi: 10.1016/0277-9536(91)90212-u. [DOI] [PubMed] [Google Scholar]
  12. West P. Rethinking the health selection explanation for health inequalities. Soc Sci Med. 1991;32(4):373–384. doi: 10.1016/0277-9536(91)90338-d. [DOI] [PubMed] [Google Scholar]
  13. Wilkinson R. G. Income distribution and life expectancy. BMJ. 1992 Jan 18;304(6820):165–168. doi: 10.1136/bmj.304.6820.165. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Wilkinson R. G. National mortality rates: the impact of inequality? Am J Public Health. 1992 Aug;82(8):1082–1084. doi: 10.2105/ajph.82.8.1082. [DOI] [PMC free article] [PubMed] [Google Scholar]

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