Mortality Attributable to Low Levels of Education in the United States

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2015 Jul 9

PMID 26153885

Citations 37

Authors

Patrick M Krueger

Melanie K Tran

Robert A Hummer

Virginia W Chang

Affiliations

Soon will be listed here.

Abstract

Background: Educational disparities in U.S. adult mortality are large and have widened across birth cohorts. We consider three policy relevant scenarios and estimate the mortality attributable to: (1) individuals having less than a high school degree rather than a high school degree, (2) individuals having some college rather than a baccalaureate degree, and (3) individuals having anything less than a baccalaureate degree rather than a baccalaureate degree, using educational disparities specific to the 1925, 1935, and 1945 cohorts.

Methods: We use the National Health Interview Survey data (1986-2004) linked to prospective mortality through 2006 (N=1,008,949), and discrete-time survival models, to estimate education- and cohort-specific mortality rates. We use those mortality rates and data on the 2010 U.S. population from the American Community Survey, to calculate annual attributable mortality estimates.

Results: If adults aged 25-85 in the 2010 U.S. population experienced the educational disparities in mortality observed in the 1945 cohort, 145,243 deaths could be attributed to individuals having less than a high school degree rather than a high school degree, 110,068 deaths could be attributed to individuals having some college rather than a baccalaureate degree, and 554,525 deaths could be attributed to individuals having anything less than a baccalaureate degree rather than a baccalaureate degree. Widening educational disparities between the 1925 and 1945 cohorts result in a doubling of attributable mortality. Mortality attributable to having less than a high school degree is proportionally similar among women and men and among non-Hispanic blacks and whites, and is greater for cardiovascular disease than for cancer.

Conclusions: Mortality attributable to low education is comparable in magnitude to mortality attributable to individuals being current rather than former smokers. Existing research suggests that a substantial part of the association between education and mortality is causal. Thus, policies that increase education could significantly reduce adult mortality.

Citing Articles

Social Determinants of Health in a Kansas Community Health Center.

Schmidt R, Butler F Kans J Med. 2024; 17:61-63.

PMID: 38859989 PMC: 11164425. DOI: 10.17161/kjm.vol17.21220.

A sociocultural approach to voting: Construing voting as a duty to others predicts political interest and engagement.

Waldfogel H, Dittmann A, Birnbaum H Proc Natl Acad Sci U S A. 2024; 121(22):e2215051121.

PMID: 38768346 PMC: 11145289. DOI: 10.1073/pnas.2215051121.

Mortality in Women across the CGG Repeat Range: The Neuroprotective Effect of Higher Education.

Hong J, Dembo R, DaWalt L, Baker M, Berry-Kravis E, Mailick M Cells. 2023; 12(17).

PMID: 37681869 PMC: 10486613. DOI: 10.3390/cells12172137.

Excess Deaths in the United States Compared to 18 Other High-Income Countries.

Dehry S, Krueger P Popul Res Policy Rev. 2023; 42(2):27.

PMID: 36970708 PMC: 10030346. DOI: 10.1007/s11113-023-09762-6.

Genetic and shared environmental factors explain the association between adolescent polysubstance use and high school noncompletion.

Davis C, Gizer I, Agrawal A, Statham D, Heath A, Martin N Psychol Addict Behav. 2023; 38(1):114-123.

PMID: 36913302 PMC: 10497723. DOI: 10.1037/adb0000915.

References

Rogers R, Everett B, Zajacova A, Hummer R . Educational degrees and adult mortality risk in the United States. Biodemography Soc Biol. 2010; 56(1):80-99. PMC: 3184464. DOI: 10.1080/19485561003727372. View

Link B, Phelan J, Miech R, Westin E . The resources that matter: fundamental social causes of health disparities and the challenge of intelligence. J Health Soc Behav. 2008; 49(1):72-91. DOI: 10.1177/002214650804900106. View

Lantz P, House J, Lepkowski J, Williams D, Mero R, Chen J . Socioeconomic factors, health behaviors, and mortality: results from a nationally representative prospective study of US adults. JAMA. 1998; 279(21):1703-8. DOI: 10.1001/jama.279.21.1703. View

Baker D, Leon J, Smith Greenaway E, Collins J, Movit M . The education effect on population health: a reassessment. Popul Dev Rev. 2011; 37(2):307-32. PMC: 3188849. DOI: 10.1111/j.1728-4457.2011.00412.x. View

Woolf S, Johnson R, Phillips Jr R, Philipsen M . Giving everyone the health of the educated: an examination of whether social change would save more lives than medical advances. Am J Public Health. 2007; 97(4):679-83. PMC: 1829331. DOI: 10.2105/AJPH.2005.084848. View

Montez J, Hummer R, Hayward M, Woo H, Rogers R . Trends in the Educational Gradient of U.S. Adult Mortality from 1986 to 2006 by Race, Gender, and Age Group. Res Aging. 2011; 33(2):145-171. PMC: 3166515. DOI: 10.1177/0164027510392388. View

Kirch D, Mitchell K, Ast C . The new 2015 MCAT: testing competencies. JAMA. 2013; 310(21):2243-4. DOI: 10.1001/jama.2013.282093. View

Meara E, Richards S, Cutler D . The gap gets bigger: changes in mortality and life expectancy, by education, 1981-2000. Health Aff (Millwood). 2008; 27(2):350-60. PMC: 2366041. DOI: 10.1377/hlthaff.27.2.350. View

Masters R, Hummer R, Powers D . Educational Differences in U.S. Adult Mortality: A Cohort Perspective. Am Sociol Rev. 2014; 77(4):548-572. PMC: 4208076. DOI: 10.1177/0003122412451019. View

10.

Hummer R, Hernandez E . The Effect of Educational Attainment on Adult Mortality in the United States. Popul Bull. 2015; 68(1):1-16. PMC: 4435622. View

11.

Deaton A . Policy implications of the gradient of health and wealth. Health Aff (Millwood). 2002; 21(2):13-30. DOI: 10.1377/hlthaff.21.2.13. View

12.

Pampel F . Diffusion, cohort change, and social patterns of smoking(). Soc Sci Res. 2012; 34(1):117-139. PMC: 3319442. DOI: 10.1016/j.ssresearch.2003.12.003. View

13.

Wong M, Shapiro M, Boscardin W, Ettner S . Contribution of major diseases to disparities in mortality. N Engl J Med. 2002; 347(20):1585-92. DOI: 10.1056/NEJMsa012979. View

14.

Mokdad A, Marks J, Stroup D, Gerberding J . Actual causes of death in the United States, 2000. JAMA. 2004; 291(10):1238-45. DOI: 10.1001/jama.291.10.1238. View

15.

Rogers R, Hummer R, Krueger P, Pampel F . COMBINING PREVALENCE AND MORTALITY RISK RATES: THE CASE OF CIGARETTE SMOKING. Popul Dev Rev. 2014; 31(2):259-292. PMC: 4098763. DOI: 10.1111/j.1728-4457.2005.00065.x. View

16.

Korn E, Graubard B, Midthune D . Time-to-event analysis of longitudinal follow-up of a survey: choice of the time-scale. Am J Epidemiol. 1997; 145(1):72-80. DOI: 10.1093/oxfordjournals.aje.a009034. View

17.

Kawachi I, Adler N, Dow W . Money, schooling, and health: Mechanisms and causal evidence. Ann N Y Acad Sci. 2010; 1186:56-68. DOI: 10.1111/j.1749-6632.2009.05340.x. View

18.

Greenland S . Dose-response and trend analysis in epidemiology: alternatives to categorical analysis. Epidemiology. 1995; 6(4):356-65. DOI: 10.1097/00001648-199507000-00005. View

19.

Goldman D, Smith J . The increasing value of education to health. Soc Sci Med. 2011; 72(10):1728-37. PMC: 3119491. DOI: 10.1016/j.socscimed.2011.02.047. View

20.

Olshansky S, Antonucci T, Berkman L, Binstock R, Boersch-Supan A, Cacioppo J . Differences in life expectancy due to race and educational differences are widening, and many may not catch up. Health Aff (Millwood). 2012; 31(8):1803-13. DOI: 10.1377/hlthaff.2011.0746. View