Educational Disparities in Adult Mortality Across US States: How Do They Differ, and Have They Changed Since the Mid-1980s?
Educational Disparities in Adult Mortality Across US States: How Do They Differ, and Have They Changed Since the Mid-1980s?
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DOI：
10.1007/s13524-018-0750-z
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发表时间：
2019-04-01
期刊：
影响因子：
3.5
通讯作者：
Beckfield, Jason
中科院分区：
文献类型：
--
作者：
Montez, Jennifer Karas;Zajacova, Anna;Beckfield, Jason
成人死亡率因受教育程度的不同而有很大差异。解释的重点是个人的行动和选择，忽视了经济和政策环境等背景因素。这项研究采取了重要的一步，通过检查美国各州，解释了自20世纪80年代中期以来美国成年人死亡率及其增长的教育差异。我们分析了1985-2011年国家健康访谈调查相关死亡率文件中45-89岁成人的数据（721，448名成人; 225，592例死亡）。我们比较了21世纪初（1999-2011年）与20世纪末（1985-1998年）36个大样本州的死亡率教育差异，解释了人口统计协变量和出生状态。我们发现，各州之间的差异有很大差异：在21世纪初，与完成至少一年大学教育相比，缺乏高中学历的死亡风险更大，从亚利桑那州的40%到104%不等。马里兰州。各州之间差异的大小不同，主要是因为与低教育相关的死亡率不同。在这两个时期之间，受教育程度较高的成年人死亡率在大多数州下降到相似的水平，但受教育程度较低的成年人死亡率下降，增加或变化不大，这取决于州。因此，随着时间的推移，在许多州（但不是所有州），死亡率的教育差距不断扩大，其中南部和中西部的增长最为常见。这些发现为美国成人死亡率的令人不安的趋势和差异提供了新的见解。
Adult mortality varies greatly by educational attainment. Explanations have focused on actions and choices made by individuals, neglecting contextual factors such as economic and policy environments. This study takes an important step toward explaining educational disparities in U.S. adult mortality and their growth since the mid-1980s by examining them across U.S. states. We analyzed data on adults aged 45-89 in the 1985-2011 National Health Interview Survey Linked Mortality File (721,448 adults; 225,592 deaths). We compared educational disparities in mortality in the early twenty-first century (1999-2011) with those of the late twentieth century (1985-1998) for 36 large-sample states, accounting for demographic covariates and birth state. We found that disparities vary considerably by state: in the early twenty-first century, the greater risk of death associated with lacking a high school credential, compared with having completed at least one year of college, ranged from 40 % in Arizona to 104 % in Maryland. The size of the disparities varies across states primarily because mortality associated with low education varies. Between the two periods, higher-educated adult mortality declined to similar levels across most states, but lower-educated adult mortality decreased, increased, or changed little, depending on the state. Consequently, educational disparities in mortality grew over time in many, but not all, states, with growth most common in the South and Midwest. The findings provide new insights into the troubling trends and disparities in U.S. adult mortality.