Educational Differences in U.S. Adult Mortality

描述(由申请人提供)：美国在死亡率方面持续存在的教育差异是一个令人担忧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，受过高中以下教育的美国成年人在五年的随访期内死亡的风险几乎是后者的两倍。这意味着受教育群体在25岁时的预期寿命存在5至7岁的差异，具体取决于所涉及的性别和种族/民族。我们研究的总体目标是提高对教育程度与整个人口内和成人人口不同亚群之间的总体和特定原因的成人死亡率之间的联系的理解。尽管两国之间的总体关系 自从北川-豪泽(1973)的经典研究使用1960年的数据以来，教育水平与成人死亡风险之间的关系一直被很好地记录下来，令人惊讶的是，很少有人关注这种关系如何随种族/民族、出生地、性别、年龄和死因的变化而变化。此外，关于教育对死亡率的差异随着时间的推移在多大程度上扩大或缩小，教育对死亡率的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卫生变量如何调节教育与死亡风险之间的关系，存在着相当大的争论。我们将使用国家健康访谈调查-多死因调查(NHIS-MCD)链接文件中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因随后长达17年的生存状态而接受跟踪；(2)超过100,000人被确认为随后死亡，并提供有关死亡日期和原因的信息；(3)足够多的种族/民族/出生地、性别和年龄多样性，以检查特定人口亚群的非常详细的死亡模式；(4)足够长的时间段，以检查教育死亡率关系中的持续时间和队列差异。此外，这些数据还提供了社会经济地位的衡量标准(包括家庭收入、就业状况和职业状况)以及吸烟、体重和身高的信息，这将使我们更好地了解教育如何至少部分地通过其他社会经济变量、吸烟和身高体重比来影响美国成年人的死亡风险。这项拟议的研究涉及到一个巨大的科学和公共政策主题。 并将有助于了解目前在健康变化、健康行为和终身残疾轨迹方面的教育差异的大量其他工作。

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.