title: Educational level and stroke mortality: a comparison of 10 European populations during the 1990s.
abstract: OBJECTIVE
  Variations between countries in occupational differences in stroke mortality were observed among men during the 1980s. This study estimates the magnitude of differences in stroke mortality by educational level among men and women aged >or=30 years in 10 European populations during the 1990s.
  
  
  METHODS
  Longitudinal data from mortality registries were obtained for 10 European populations, namely Finland, Norway, Denmark, England/Wales, Belgium, Switzerland, Austria, Turin (Italy), Barcelona (Spain), and Madrid (Spain). Rate ratios (RRs) were calculated to assess the association between educational level and stroke mortality. The life table method was used to estimate the impact of stroke mortality on educational differences in life expectancy.
  
  
  RESULTS
  Differences in stroke mortality according to educational level were of a similar magnitude in most populations. However, larger educational differences were observed in Austria. Overall, educational differences in stroke mortality were of similar size among men (RR, 1.27; 95% CI, 1.24 to 1.30) and women (RR, 1.29; 95% CI, 1.27 to 1.32). Educational differences in stroke mortality persisted at all ages in all populations, although they generally decreased with age. Eliminating these differences would on average reduce educational differences in life expectancy by 7% among men and 14% among women.
  
  
  CONCLUSIONS
  Educational differences in stroke mortality were observed across Europe during the 1990s. Risk factors such as hypertension and smoking may explain part of these differences in several countries. Other factors, such as socioeconomic differences in healthcare utilization and childhood socioeconomic conditions, may have contributed to educational differences in stroke mortality across Europe.
authors.affiliation: Department of Public Health, Erasmus Medical Center, PO Box 1738, 3000 DR Rotterdam, Netherlands. m.avendanopabon@erasmusmc.nl
authors.forename: Mauricio
authors.initials: M
authors.lastname: Avendaño
authors.forename: Anton E
authors.initials: AE
authors.lastname: Kunst
authors.forename: Martijn
authors.initials: M
authors.lastname: Huisman
authors.forename: Frank
authors.initials: F
authors.lastname: van Lenthe
authors.forename: Matthias
authors.initials: M
authors.lastname: Bopp
authors.forename: Carme
authors.initials: C
authors.lastname: Borrell
authors.forename: Tapani
authors.initials: T
authors.lastname: Valkonen
authors.forename: Enrique
authors.initials: E
authors.lastname: Regidor
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Costa
authors.forename: Angela
authors.initials: A
authors.lastname: Donkin
authors.forename: Jens-Kristian
authors.initials: JK
authors.lastname: Borgan
authors.forename: Patrick
authors.initials: P
authors.lastname: Deboosere
authors.forename: Sylvie
authors.initials: S
authors.lastname: Gadeyne
authors.forename: Teresa
authors.initials: T
authors.lastname: Spadea
authors.forename: Otto
authors.initials: O
authors.lastname: Andersen
authors.forename: Johan P
authors.initials: JP
authors.lastname: Mackenbach
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004522:Educational Status; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008017:Life Expectancy; D015993:Life Tables; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012042:Registries / Q000706:statistics & numerical data; D017678:Sex Distribution; D020521:Stroke / Q000401:mortality*