title: Trends in mortality risk by education level and cause of death among US White women from 1986 to 2006.
abstract: OBJECTIVE
  To elucidate why the inverse association between education level and mortality risk (the gradient) has increased markedly among White women since the mid-1980s, we identified causes of death for which the gradient increased.
  
  
  METHODS
  We used data from the 1986 to 2006 National Health Interview Survey Linked Mortality File on non-Hispanic White women aged 45 to 84 years (n = 230 692). We examined trends in the gradient by cause of death across 4 time periods and 4 education levels using age-standardized death rates.
  
  
  RESULTS
  During 1986 to 2002, the growing gradient for all-cause mortality reflected increasing mortality among low-educated women and declining mortality among college-educated women; during 2003 to 2006 it mainly reflected declining mortality among college-educated women. The gradient increased for heart disease, lung cancer, chronic lower respiratory disease, cerebrovascular disease, diabetes, and Alzheimer's disease. Lung cancer and chronic lower respiratory disease explained 47% of the overall increase.
  
  
  CONCLUSIONS
  Mortality disparities among White women widened across 1986 to 2006 partially because of causes of death for which smoking is a major risk factor. A comprehensive policy framework should address the social conditions that influence smoking among disadvantaged women.
authors: Harvard Center for Population and Development Studies, Harvard University, Cambridge MA 02138, USA. jkmontez@hsph.harvard.edu
authors: Jennifer Karas
authors: JK
authors: Montez
authors: Anna
authors: A
authors: Zajacova
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death / Q000639:trends*; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*; D014930:Women