title: Education and Mortality in the Rome Longitudinal Study.
abstract: BACKGROUND
  A large body of evidence supports an inverse association between socioeconomic status and mortality. We analysed data from a large cohort of residents in Rome followed-up between 2001 and 2012 to assess the relationship between individual education and mortality. We distinguished five causes of death and investigated the role of age, gender, and birthplace.
  
  
  METHODS
  From the Municipal Register we enrolled residents of Rome on October 21st 2001 and collected information on educational level attained from the 2001 Census. We selected Italian citizens aged 30-74 years and followed-up their vital status until 2012 (n = 1,283,767), identifying the cause of death from the Regional Mortality Registry. We calculated hazard ratios (HRs) for overall and cause-specific mortality in relation to education. We used age, gender, and birthplace for adjusted or stratified analyses. We used the inverse probability weighting approach to account for right censoring due to emigration.
  
  
  RESULTS
  We observed an inverse association between education (none vs. post-secondary+ level) and overall mortality (HRs(95%CIs): 2.1(1.98-2.17), males; 1.5(1.46-1.59), females) varying according to demographic characteristics. Cause-specific analysis also indicated an inverse association with education, in particular for respiratory, digestive or circulatory system related-mortality, and the youngest people seemed to be more vulnerable to low education.
  
  
  CONCLUSIONS
  Our results confirm the inverse association between education and overall or cause-specific mortality and show differentials particularly marked among young people compared to the elderly. The findings provide further evidence from the Mediterranean area, and may contribute to national and cross-country comparisons in Europe to understand the mechanisms generating socioeconomic differentials especially during the current recession period.
authors.affiliation: Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Cacciani
authors.affiliation: Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Bargagli
authors.affiliation: Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Cesaroni
authors.affiliation: Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Forastiere
authors.affiliation: Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
authors.forename: Nera
authors.initials: N
authors.lastname: Agabiti
authors.affiliation: Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Davoli
mesh_terms: D000328:Adult; D000368:Aged; D019352:Censuses; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality; D012923:Social Class