title: Four Decades of Educational Inequalities in Hospitalization and Mortality among Older Swedes.
abstract: BACKGROUND
  The inverse association between education and mortality has grown stronger the last decades in many countries. During the same period, gains in life expectancy have been concentrated to older ages; still, old-age mortality is seldom the focus of attention when analyzing trends in the education-mortality gradient. It is further unknown if increased educational inequalities in mortality are preceded by increased inequalities in morbidity of which hospitalization may be a proxy.
  
  
  METHODS
  Using administrative population registers from 1971 and onwards, education-specific annual changes in the risk of death and hospital admission were estimated with complimentary log-log models. These risk changes were supplemented by estimations of the ages at which 25, 50, and 75% of the population had been hospitalized or died (after age 60).
  
  
  RESULTS
  The mortality decline among older people increasingly benefitted the well-educated over the less well-educated. This inequality increase was larger for the younger old, and among men. Educational inequalities in the age of a first hospital admission generally followed the development of growing gaps, but at a slower pace than mortality and inequalities did not increase among the oldest individuals.
  
  
  CONCLUSIONS
  Education continues to be a significant predictor of health and longevity into old age. That the increase in educational inequalities is greater for mortality than for hospital admissions (our proxy of overall morbidity) may reflect that well-educated individuals gradually have obtained more possibilities or resources to survive a disease than less well-educated individuals have the last four decades.
authors.affiliation: The Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden.
authors.forename: Jenny
authors.initials: J
authors.lastname: Torssander
authors.affiliation: The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Ahlbom
authors.affiliation: The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Modig
mesh_terms: D000368:Aged; D004522:Educational Status; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012306:Risk; D017678:Sex Distribution; D013548:Sweden / Q000453:epidemiology