The contribution of educational inequalities to lifespan variation
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RESEARCH
Open Access
The contribution of educational inequalities to lifespan variation Alyson A van Raalte1,2*, Anton E Kunst3, Olle Lundberg4,5, Mall Leinsalu6,7, Pekka Martikainen8, Barbara Artnik9, Patrick Deboosere10, Irina Stirbu2, Bogdan Wojtyniak11 and Johan P Mackenbach2
Abstract Background: Studies of socioeconomic inequalities in mortality consistently point to higher death rates in lower socioeconomic groups. Yet how these between-group differences relate to the total variation in mortality risk between individuals is unknown. Methods: We used data assembled and harmonized as part of the Eurothine project, which includes census-based mortality data from 11 European countries. We matched this to national data from the Human Mortality Database and constructed life tables by gender and educational level. We measured variation in age at death using Theil’s entropy index, and decomposed this measure into its between- and within-group components. Results: The least-educated groups lived between three and 15 years fewer than the highest-educated groups, the latter having a more similar age at death in all countries. Differences between educational groups contributed between 0.6% and 2.7% to total variation in age at death between individuals in Western European countries and between 1.2% and 10.9% in Central and Eastern European countries. Variation in age at death is larger and differs more between countries among the least-educated groups. Conclusions: At the individual level, many known and unknown factors are causing enormous variation in age at death, socioeconomic position being only one of them. Reducing variations in age at death among less-educated people by providing protection to the vulnerable may help to reduce inequalities in mortality between socioeconomic groups. Keywords: Lifespan variation, Life expectancy, Socioeconomic inequality, Education, International variation, Mortality
Introduction Individuals vary greatly in lifespan. For instance, comparing the age at death of European males at the individual level to that of every other male in the same country, the average difference is around 7.5 to 10.5 years, depending on the country. a This variation in lifespan has many sources, including genetic factors, lifestyle factors, socioeconomic conditions, chance, etc. One of these sources, differential mortality by socioeconomic group, has been the subject of much research. A recent European crosscountry comparison revealed higher death rates in lower educational groups in all 16 populations studied, with particularly large educational differences in mortality in * Correspondence: [email protected] 1 Max Planck Institute for Demographic Research, Rostock, Germany Full list of author information is available at the end of the article
parts of Central and Eastern Europe [1]. What is unknown, however, is the contribution of these betweengroup differences to all between-individual differences. This relates to the debate sparked by the release of the World Health Report 2000 about whether li
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