Educational inequalities in diabetes mortality across Europe in the 2000s: the interaction with gender.
OBJECTIVE
To evaluate educational inequalities in diabetes mortality in Europe in the 2000s, and to assess whether these inequalities differ between genders.


METHODS
Data were obtained from mortality registries covering 14 European countries. To determine educational inequalities in diabetes mortality, age-standardised mortality rates, mortality rate ratios, and slope and relative indices of inequality were calculated. To assess whether the association between education and diabetes mortality differs between genders, diabetes mortality was regressed on gender, educational rank and 'gender × educational rank'.


RESULTS
An inverse association between education and diabetes mortality exists in both genders across Europe. Absolute educational inequalities are generally larger among men than women; relative inequalities are generally more pronounced among women, the relative index of inequality being 2.8 (95 % CI 2.0-3.9) in men versus 4.8 (95 % CI 3.2-7.2) in women. Gender inequalities in diabetes mortality are more marked in the highest than the lowest educated.


CONCLUSIONS
Education and diabetes mortality are inversely related in Europe in the 2000s. This association differs by gender, indicating the need to take the socioeconomic and gender dimension into account when developing public health policies.
Interface Demography, Department of Sociology, Vrije Universiteit Brussel, 5 Pleinlaan, 1050, Brussels, Belgium, Hadewijch.Vandenheede@vub.ac.be.
Hadewijch
H
Vandenheede
Patrick
P
Deboosere
Albert
A
Espelt
Matthias
M
Bopp
Carme
C
Borrell
Giuseppe
G
Costa
Terje Andreas
TA
Eikemo
Roberto
R
Gnavi
Rasmus
R
Hoffmann
Ivana
I
Kulhanova
Margarete
M
Kulik
Mall
M
Leinsalu
Pekka
P
Martikainen
Gwenn
G
Menvielle
Maica
M
Rodriguez-Sanz
Jitka
J
Rychtarikova
Johan P
JP
Mackenbach
D003920:Diabetes Mellitus / Q000401:mortality*; D004522:Educational Status; D005060:Europe / Q000453:epidemiology; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D012737:Sex Factors