Educational Differences in U.S. Adult Mortality

描述（由申请人提供）：美国死亡率的持续教育差异是一个令人不安和具有挑战性的问题。最近的研究发现，与拥有研究生学位的成年人相比，高中以下教育程度的美国成年人在五年随访期内的死亡风险几乎是其两倍。这意味着，根据具体性别和种族/族裔群体的不同，受教育群体在25岁时的预期寿命有5至7年的差异。我们研究的总体目标是，更好地了解教育程度与整个人口和成年人口各亚群的总体和具体原因的成年人死亡率之间的联系。虽然整体关系 自从Kitagawa-Hauser（1973）使用1960年的数据进行经典研究以来，教育水平和成人死亡风险之间的关系已经得到了很好的记录，但令人惊讶的是，很少有人关注这种关系如何因种族/民族、出生地、性别、年龄和死因而变化。此外，关于教育在死亡率方面的差异随着时间的推移而扩大或缩小的程度，死亡率方面的教育差异是否随着年龄的增长而扩大或缩小，以及其他社会经济和健康变量如何调节教育与死亡风险之间的关系，存在着相当多的争论。我们将使用来自国家健康访谈调查-多种死因（NHIS-MCD）链接文件的数据来实现我们的目标。MCD将2002年的全国死亡指数与1986年至2000年的NHIS横截面波动联系起来。这些相关数据提供了以下信息：（1）近100万25岁及以上的美国成年人随访了长达17年的后续生存状态;（2）超过10万例已确定的后续死亡，包括死亡日期和死亡原因的信息;（3）足够的种族/民族/出生地、性别和年龄多样性，以研究特定人口亚群的非常详细的死亡率模式;（4）足够长的时间来研究教育死亡率关系中的持续时间和队列差异。此外，社会经济地位的措施（包括家庭收入，就业状况和职业地位）和吸烟，体重和身高的信息在这些数据中可用，这将使我们能够更好地了解教育，至少部分，如何通过其他社会经济变量，吸烟和体重身高影响美国成年人死亡风险。这项拟议中的研究涉及到一个巨大的科学和公共政策问题。 感兴趣，并将有助于通知大量其他目前的工作，审查教育差异的健康变化，健康行为，残疾轨迹在整个生命过程中。

DESCRIPTION (provided by applicant): The persistent educational differences in mortality in the United States represent a troubling and challenging issue. Recent research finds that U.S. adults with less than a high school education had nearly twice the risk of mortality in a five-year follow-up period compared to adults with graduate degrees. This translates into 5-to-7 years of differential life expectancy at age 25 across educational groups, depending on the specific sex and racial/ethnic group in question. The overall goal of our research is to improve the understanding of the linkage between educational attainment and overall and cause-specific adult mortality within the population as a whole and among various subgroups of the adult population. Although the overall relationship between educational level and adult mortality risk has been quite well documented since the classic Kitagawa-Hauser (1973) study that used 1960 data, surprisingly little attention has been given to how this relationship varies by race/ethnicity, nativity, gender, age, and cause of death. Further, there are considerable debates regarding the extent to which educational differences in mortality have been widening or narrowing over time, whether or not educational differences in mortality widen or narrow with increasing age, and how other socioeconomic and health variables mediate the relationship between education and mortality risk. We will use data from the National Health Interview Survey-Multiple Cause of Death (NHIS-MCD) linked files to accomplish our goal. The MCD links the National Death Index through 2002 to the 1986 through 2000 cross-sectional waves of the NHIS. These linked data provide information on: (1) nearly 1 million U.S. adults aged 25 and above followed for subsequent survival status for up to 17 years; (2) over 100,000 identified subsequent deaths, with information on both date and cause of death; (3) enough racial/ethnic/nativity, gender, and age diversity to examine very detailed patterns of mortality for specific subgroups of the population; (4) a long enough time period to examine duration and cohort differences in the education mortality relationship. Further, measures of socioeconomic status (including family income, employment status, and occupational status) and information on cigarette smoking and body weight and height are available in these data, which will allow us to better understand how education, at least in part, may work through other socioeconomic variables, cigarette smoking, and weight-for-height to influence adult mortality risks in the United States. The proposed research addresses a topic of immense scientific and public policy interest and will help to inform a great deal of other current work that examines educational differences in health changes, health behavior, and disability trajectories throughout the life course.