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Widening educational inequalities in mortality in more recent birth cohorts: a study of 14 European countries.
Erasmus MC, Netherlands.ORCID iD: 0000-0001-6493-9314
Erasmus MC, Netherlands.
Vrije Universiteit Amsterdam, Netherlands.ORCID iD: 0000-0002-9229-1778
Lithuanian University of Health Sciences, Lithuania.
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2023 (English)In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 77, no 6, p. 400-408Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Studies of period changes in educational inequalities in mortality have shown important changes over time. It is unknown whether a birth cohort perspective paints the same picture. We compared changes in inequalities in mortality between a period and cohort perspective and explored mortality trends among low-educated and high-educated birth cohorts.

DATA AND METHODS: In 14 European countries, we collected and harmonised all-cause and cause-specific mortality data by education for adults aged 30-79 years in the period 1971-2015. Data reordered by birth cohort cover persons born between 1902 and 1976. Using direct standardisation, we calculated comparative mortality figures and resulting absolute and relative inequalities in mortality between low educated and high educated by birth cohort, sex and period.

RESULTS: Using a period perspective, absolute educational inequalities in mortality were generally stable or declining, and relative inequalities were mostly increasing. Using a cohort perspective, both absolute and relative inequalities increased in recent birth cohorts in several countries, especially among women. Mortality generally decreased across successive birth cohorts among the high educated, driven by mortality decreases from all causes, with the strongest reductions for cardiovascular disease mortality. Among the low educated, mortality stabilised or increased in cohorts born since the 1930s in particular for mortality from cardiovascular diseases, lung cancer, chronic obstructive pulmonary disease and alcohol-related causes.

CONCLUSIONS: Trends in mortality inequalities by birth cohort are less favourable than by calendar period. In many European countries, trends among more recently born generations are worrying. If current trends among younger birth cohorts persist, educational inequalities in mortality may further widen.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2023. Vol. 77, no 6, p. 400-408
Keywords [en]
death, inequalities, mortality
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Baltic and East European studies
Identifiers
URN: urn:nbn:se:sh:diva-51386DOI: 10.1136/jech-2023-220342ISI: 000981509400001PubMedID: 37094941Scopus ID: 2-s2.0-85159542031OAI: oai:DiVA.org:sh-51386DiVA, id: diva2:1753047
Available from: 2023-04-25 Created: 2023-04-25 Last updated: 2023-06-02Bibliographically approved

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