Educational gains in cause-specific mortality: Accounting for cognitive ability and family-level confounders using propensity score weighting
Educational gains in cause-specific mortality: Accounting for cognitive ability and family-level confounders using propensity score weighting
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DOI：
10.1016/j.socscimed.2017.05.019
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发表时间：
2017-07-01
影响因子：
5.4
通讯作者：
Rasmussen, Finn
中科院分区：
文献类型：
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作者：
Bijwaard, Govert E.;Myrskylae, Mikko;Rasmussen, Finn
许多死亡原因的教育程度都是负的。这种联系可能部分是由影响教育程度和死亡率的混杂因素解释的。我们使用一种创新的方法，根据特定死因损失的月数，重新加权达到更高教育水平的可能性，修正了已观察到的个人背景和未观察到的家庭因素的特定原因教育梯度。我们使用瑞典军队征兵登记处(1951-1983年)与行政登记相关联的有兄弟的男子的数据。这个约有70万名男性的数据集让我们能够区分五种教育水平和多种死因。经验结果表明，将教育水平从小学提高到大学，将导致18岁至63岁之间多活20个月。死亡率的这一改善主要归因于外部原因死亡的减少。受过高等教育的人由于外部原因死亡的减少而增加了9个月以上，但由于癌症死亡率的减少而增加了2个月，由于心血管死亡率的减少而增加了4个月。忽视混淆将导致低估受教育程度的收益，尤其是对受教育程度较低的人。我们的结果表明，如果将1951年队列中50,000名瑞典男性的教育分布替换为相应的1983年队列的教育分布，那么18岁至63岁之间死亡的人年的22%将被保存到这个队列中。(C)2017爱思唯尔有限公司。保留所有权利。
A negative educational gradient has been found for many causes of death. This association may be partly explained by confounding factors that affect both educational attainment and mortality. We correct the cause-specific educational gradient for observed individual background and unobserved family factors using an innovative method based on months lost due to a specific cause of death re-weighted by the probability of attaining a higher educational level. We use data on men with brothers from the Swedish Military Conscription Registry (1951-1983), linked to administrative registers. This dataset of some 700,000 men allows us to distinguish between five education levels and many causes of death. The empirical results reveal that raising the educational level from primary to tertiary would result in an additional 20 months of survival between ages 18 and 63. This improvement in mortality is mainly attributable to fewer deaths from external causes. The highly educated gain more than nine months due to the reduction in deaths from external causes, but gain only two months due to the reduction in cancer mortality and four months due to the reduction in cardiovascular mortality. Ignoring confounding would lead to an underestimation of the gains by educational attainment, especially for the less educated. Our results imply that if the education distribution of 50,000 Swedish men from the 1951 cohort were replaced with that of the corresponding 1983 cohort, 22% of the person-years that were lost to death between ages 18 and 63 would have been saved for this cohort. (C) 2017 Elsevier Ltd. All rights reserved.