More variation in lifespan in lower educated groups: evidence from 10 European countries

• Published in: International journal of epidemiology 2011-12, Vol.40 (6), p.1703-1714
• Main Authors: van Raalte, Alyson A, Kunst, Anton E, Deboosere, Patrick, Leinsalu, Mall, Lundberg, Olle, Martikainen, Pekka, Strand, Bjørn Heine, Artnik, Barbara, Wojtyniak, Bogdan, Mackenbach, Johan P
• Format: Article
• Language: English
• Subjects: Adult; Age; Age Distribution; Aged; Aged, 80 and over; Biological and medical sciences; education; Educational Status; Epidemiology; Europe - epidemiology; Female; General aspects; Global Health; Health Status Disparities; Humans; Injuries; international variation; Life Expectancy; Life span; Lifespan variation; Male; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Miscellaneous; Mortality; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk reduction; Sex Distribution; Social Class; socio-economic inequality; Socioeconomics; Survival
• ISSN: 0300-5771; 1464-3685; 1464-3685
• DOI: 10.1093/ije/dyr146

Background Whereas it is well established that people with a lower socio-economic position have a shorter average lifespan, it is less clear what the variability surrounding these averages is. We set out to examine whether lower educated groups face greater variation in lifespans in addition to having a shorter life expectancy, in order to identify entry points for policies to reduce the impact of socio-economic position on mortality. Methods We used harmonized, census-based mortality data from 10 European countries to construct life tables by sex and educational level (low, medium, high). Variation in lifespan was measured by the standard deviation conditional upon survival to age 35 years. We also decomposed differences between educational groups in lifespan variation by age and cause of death. Results Lifespan variation was higher among the lower educated in every country, but more so among men and in Eastern Europe. Although there was an inverse relationship between average life expectancy and its standard deviation, the first did not completely predict the latter. Greater lifespan variation in lower educated groups was largely driven by conditions causing death at younger ages, such as injuries and neoplasms. Conclusions Lower educated individuals not only have shorter life expectancies, but also face greater uncertainty about the age at which they will die. More priority should be given to efforts to reduce the risk of an early death among the lower educated, e.g. by strengthening protective policies within and outside the health-care system.