More variation in lifespan in lower educated groups: evidence from 10 European countries
More variation in lifespan in lower educated groups: evidence from 10 European countries
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DOI：
10.1093/ije/dyr146
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发表时间：
2011-12-01
影响因子：
7.7
通讯作者：
Mackenbach, Johan P.
中科院分区：
文献类型：
--
作者：
van Raalte, Alyson A.;Kunst, Anton E.;Mackenbach, Johan P.
虽然社会经济地位较低的人平均寿命较短这一事实已得到充分证实，但围绕这些平均值的可变性是什么却不太清楚。我们着手研究受教育程度较低的群体除了预期寿命较短外，是否面临更大的寿命差异，以便确定政策的切入点，以减少社会经济地位对死亡率的影响。方法：我们使用来自10个欧洲国家的统一的基于人口普查的死亡率数据，按性别和教育水平（低、中、高）构建生命表。寿命的变化是通过生存到35岁的标准偏差来衡量的。我们还按年龄和死因分解了受教育群体之间寿命变化的差异。结果各国受教育程度较低的人的寿命差异较大，但男性和东欧的差异更大。尽管平均预期寿命与其标准差之间存在反比关系，但前者并不能完全预测后者。受教育程度较低的人群寿命差异较大，主要是由于受伤和肿瘤等导致年轻时死亡的疾病造成的。结论：受教育程度较低的人不仅预期寿命较短，而且在死亡年龄方面面临更大的不确定性。应更加优先重视努力减少受教育程度较低的人过早死亡的风险，例如通过加强保健系统内外的保护政策。
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.