The gap in life expectancy between highly educated and less educated people in the United States has grown dramatically. Almost all gains in life expectancy over the past two decades have occurred among highly educated people, according to a new study of national life expectancy data and mortality trends (Health Affairs 2008:27;350-60).
Gaps in life expectancy related to education increased by about 30% between 1981 and 2000. The authors calculate that in 2000, life expectancy for a 25 year old with, at most, education to the end of high school was 50 years, compared with 57 years for those with some college education. “The 1980s and 1990s were periods of rapidly rising life expectancy, but the mortality declines that yielded these gains did not occur evenly by education group,” say the authors. “On average, we find very little change in life expectancy among less educated black and white non-Hispanics and very substantial increases in life expectancy among the more educated.”
For 1981-8 compared with 1991-8, life expectancy at age 25 increased by 1.4 years for highly educated people but only 0.5 years for poorly educated people (P=0.014 for difference). From 1990 to 2000, life expectancy increased by 1.6 years for highly educated people but remained unchanged for poorly educated people (P<0.001 for difference).
The increase in the gap in life expectancy was most pronounced among women, regardless of race. Life expectancy at age 25 fell among less educated black and white women but increased by a year or more for more educated women. By 2000, highly educated women could expect to live more than five years longer than their less educated counterparts, in both races.
One important exception to the general pattern was that disparities in mortality related to education narrowed among young black men. “With the exception of black males, all recent gains in life expectancy at age twenty five have occurred among better educated groups, raising educational differentials in life expectancy by 30%,” say the authors.
The authors, from Harvard University, also looked at how individual conditions contributed to the rising life expectancy gaps. Heart disease, cancer, and chronic obstructive pulmonary disease contributed more than 60% of deaths in the sample in 1990 and 2000 in all race and sex groups. Heart disease and cancers excluding lung cancer contributed most (32%) to rising education differentials.
