Educational Disparities in Mortality Between Adults Aged 50-64 and 66-79 Years, U.S.
BACKGROUND
This study estimated differences in educational disparities in mortality between ages 50-64 and 66-79 years in the U.S. and explored factors contributing to the differences.


METHODS
Based on the follow-up of a nationally representative cohort in the National Longitudinal Mortality Study 2002-2011, relative differences in educational disparities (relative index of inequality) between people aged 50-64 and 66-79 years were calculated for deaths from all causes, cancer, cardiovascular disease, injuries, and other causes by sex and race/ethnicity. Analyses were conducted in 2016.


RESULTS
In all racial/ethnic-, sex-, and age-specific groups, death rates were higher among the least educated than the most educated groups for all causes combined and most specific causes except for injuries in non-Hispanic blacks. Among non-Hispanic whites, the relative index of inequality for all causes combined among the younger and older age groups was 5.6 (95% CI=4.9, 6.5) and 2.8 (95% CI=2.6, 3.0), respectively. Among non-Hispanic blacks, corresponding index values were 4.1 (95% CI=3.6, 4.6) and 1.7 (95% CI=1.6, 1.8). Larger disparities in the younger age group were also observed for cardiovascular disease, cancer, and other causes among non-Hispanic whites, non-Hispanic blacks, and all races combined.


CONCLUSIONS
Educational disparities in mortality among non-Hispanic whites and blacks were 41%-61% lower in people aged 66-79 years than in those aged 50-64 years. Various factors may contribute to diminished disparities in the elderly, including differences in access to care, health perception, stress level, lifestyle, and health behaviors with advancing age and retirement.
Surveillance and Health Services Research Program, Intramural Research Department, American Cancer Society, Atlanta, Georgia. Electronic address: jiemin.ma@cancer.org.
Jiemin
J
Ma
Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland.
Sean
S
Altekruse
National Longitudinal Mortality Study, U.S. Census Bureau, Suitland, Maryland.
Candace
C
Cosgrove
Surveillance and Health Services Research Program, Intramural Research Department, American Cancer Society, Atlanta, Georgia.
Farhad
F
Islami
Surveillance and Health Services Research Program, Intramural Research Department, American Cancer Society, Atlanta, Georgia.
Ahmedin
A
Jemal
D000368:Aged; D002423:Cause of Death; D004522:Educational Status; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000208:ethnology / Q000639:trends*; D012737:Sex Factors