Abstract
Data and methods In 14 European countries, we collected and harmonised all-cause and cause-specific mortality data by education for adults aged 30–79 years in the period 1971–2015. Data reordered by birth cohort cover persons born between 1902 and 1976. Using direct standardisation, we calculated comparative mortality figures and resulting absolute and relative inequalities in mortality between low educated and high educated by birth cohort, sex and period.
Results Using a period perspective, absolute educational inequalities in mortality were generally stable or declining, and relative inequalities were mostly increasing. Using a cohort perspective, both absolute and relative inequalities increased in recent birth cohorts in several countries, especially among women. Mortality generally decreased across successive birth cohorts among the high educated, driven by mortality decreases from all causes, with the strongest reductions for cardiovascular disease mortality. Among the low educated, mortality stabilised or increased in cohorts born since the 1930s in particular for mortality from cardiovascular diseases, lung cancer, chronic obstructive pulmonary disease and alcohol-related causes.
Conclusions Trends in mortality inequalities by birth cohort are less favourable than by calendar period. In many European countries, trends among more recently born generations are worrying. If current trends among younger birth cohorts persist, educational inequalities in mortality may further widen.
Original language | English |
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Pages (from-to) | 400-408 |
Number of pages | 9 |
Journal | Journal of Epidemiology and Community Health |
Volume | 77 |
Issue number | 6 |
Early online date | 24 Apr 2023 |
DOIs | |
Publication status | Published - Jun 2023 |
Bibliographical note
Funding Information:This study was conducted as part of the Centre for Global Health Inequalities Research (CHAIN), which is funded by the Norwegian Research Council (project number: 288638) and Erasmus Medical Center, Rotterdam, the Netherlands. Data were partly collected as part of the LIFEPATH project, which has received financial support from the European Commission (Horizon 2020 grant number 633666), and the DEMETRIQ project, which received support from the European Commission (grant numbers FP7-CP-FP and 278511). The permission of the Office for National Statistics (ONS) to use the Longitudinal Study is gratefully acknowledged, as is the help provided by staff of the Centre for Longitudinal Study Information & User Support (CeLSIUS). CeLSIUS is supported by the ESRC Census of Population Programme (award reference ES/K000365/1). The authors alone are responsible for the interpretation of the data. This work contains statistical data from ONS, which is Crown Copyright. The use of the ONS statistical data in this work does not imply the endorsement of the ONS in relation to the interpretation or analysis of the statistical data. This work uses research datasets, which might not exactly reproduce National Statistics aggregates. The mortality data for Switzerland were obtained from the Swiss National Cohort, which is based on mortality and census data provided by the Federal Statistical Office and supported by the Swiss National Science Foundation (grant nos. 3347CO-108806, 33CS30_134273 and 33CS30_148415). Pekka T. Martikainen was funded by the Academy of Finland and the MINDMAP project, which received financial support from the European Commission (Horizon 2020 grant number 667661). Mall Leinsalu was supported by the Estonian Research Council (grant PRG722). We acknowledge Bjørn Heine Strand, Carme Borell, Chris White, Eva-Maria Asamer, Gwenn Menvielle, Katalin Kovács, Olle Lundberg, for providing data.
Funding Information:
This study was conducted as part of the Centre for Global Health Inequalities Research (CHAIN), which is funded by the Norwegian Research Council (project number: 288638) and Erasmus Medical Center, Rotterdam, the Netherlands. Data were partly collected as part of the LIFEPATH project, which has received financial support from the European Commission (Horizon 2020 grant number 633666), and the DEMETRIQ project, which received support from the European Commission (grant numbers FP7-CP-FP and 278511). The permission of the Office for National Statistics (ONS) to use the Longitudinal Study is gratefully acknowledged, as is the help provided by staff of the Centre for Longitudinal Study Information & User Support (CeLSIUS). CeLSIUS is supported by the ESRC Census of Population Programme (award reference ES/K000365/1). The authors alone are responsible for the interpretation of the data. This work contains statistical data from ONS, which is Crown Copyright. The use of the ONS statistical data in this work does not imply the endorsement of the ONS in relation to the interpretation or analysis of the statistical data. This work uses research datasets, which might not exactly reproduce National Statistics aggregates. The mortality data for Switzerland were obtained from the Swiss National Cohort, which is based on mortality and census data provided by the Federal Statistical Office and supported by the Swiss National Science Foundation (grant nos. 3347CO-108806, 33CS30_134273 and 33CS30_148415). Pekka T. Martikainen was funded by the Academy of Finland and the MINDMAP project, which received financial support from the European Commission (Horizon 2020 grant number 667661). Mall Leinsalu was supported by the Estonian Research Council (grant PRG722). We acknowledge Bjørn Heine Strand, Carme Borell, Chris White, Eva-Maria Asamer, Gwenn Menvielle, Katalin Kovács, Olle Lundberg for providing data.
Publisher Copyright:
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Funding
This study was conducted as part of the Centre for Global Health Inequalities Research (CHAIN), which is funded by the Norwegian Research Council (project number: 288638) and Erasmus Medical Center, Rotterdam, the Netherlands. Data were partly collected as part of the LIFEPATH project, which has received financial support from the European Commission (Horizon 2020 grant number 633666), and the DEMETRIQ project, which received support from the European Commission (grant numbers FP7-CP-FP and 278511). The permission of the Office for National Statistics (ONS) to use the Longitudinal Study is gratefully acknowledged, as is the help provided by staff of the Centre for Longitudinal Study Information & User Support (CeLSIUS). CeLSIUS is supported by the ESRC Census of Population Programme (award reference ES/K000365/1). The authors alone are responsible for the interpretation of the data. This work contains statistical data from ONS, which is Crown Copyright. The use of the ONS statistical data in this work does not imply the endorsement of the ONS in relation to the interpretation or analysis of the statistical data. This work uses research datasets, which might not exactly reproduce National Statistics aggregates. The mortality data for Switzerland were obtained from the Swiss National Cohort, which is based on mortality and census data provided by the Federal Statistical Office and supported by the Swiss National Science Foundation (grant nos. 3347CO-108806, 33CS30_134273 and 33CS30_148415). Pekka T. Martikainen was funded by the Academy of Finland and the MINDMAP project, which received financial support from the European Commission (Horizon 2020 grant number 667661). Mall Leinsalu was supported by the Estonian Research Council (grant PRG722). We acknowledge Bjørn Heine Strand, Carme Borell, Chris White, Eva-Maria Asamer, Gwenn Menvielle, Katalin Kovács, Olle Lundberg, for providing data. This study was conducted as part of the Centre for Global Health Inequalities Research (CHAIN), which is funded by the Norwegian Research Council (project number: 288638) and Erasmus Medical Center, Rotterdam, the Netherlands. Data were partly collected as part of the LIFEPATH project, which has received financial support from the European Commission (Horizon 2020 grant number 633666), and the DEMETRIQ project, which received support from the European Commission (grant numbers FP7-CP-FP and 278511). The permission of the Office for National Statistics (ONS) to use the Longitudinal Study is gratefully acknowledged, as is the help provided by staff of the Centre for Longitudinal Study Information & User Support (CeLSIUS). CeLSIUS is supported by the ESRC Census of Population Programme (award reference ES/K000365/1). The authors alone are responsible for the interpretation of the data. This work contains statistical data from ONS, which is Crown Copyright. The use of the ONS statistical data in this work does not imply the endorsement of the ONS in relation to the interpretation or analysis of the statistical data. This work uses research datasets, which might not exactly reproduce National Statistics aggregates. The mortality data for Switzerland were obtained from the Swiss National Cohort, which is based on mortality and census data provided by the Federal Statistical Office and supported by the Swiss National Science Foundation (grant nos. 3347CO-108806, 33CS30_134273 and 33CS30_148415). Pekka T. Martikainen was funded by the Academy of Finland and the MINDMAP project, which received financial support from the European Commission (Horizon 2020 grant number 667661). Mall Leinsalu was supported by the Estonian Research Council (grant PRG722). We acknowledge Bjørn Heine Strand, Carme Borell, Chris White, Eva-Maria Asamer, Gwenn Menvielle, Katalin Kovács, Olle Lundberg for providing data.