Abstract
Objectives
To estimate educational inequalities in mortality in Spain and in three Spanish areas: Madrid, Barcelona, and the Basque country.
Methods
A national prospective study was carried out including all persons aged 25–74 years living in Spain in 2001 and followed up for mortality over 7 years. The mortality rate ratio and difference from all causes and from leading causes of death were estimated for the entire Spanish population and for the above three geographical areas.
Results
With respect to people with the highest education, the mortality rate ratios in the entire population of Spain in people with the second highest, second lowest and lowest education were, respectively, 1.09, 1.10, 1.39 in women and 1.19, 1.27 and 1.54 in men. The mortality rate differences per 100,000 person-years were, respectively, 24.8, 28.3, 108.2 in women and 116.7, 162.5 and 319.1 in men. These estimates were intermediate in magnitude compared to those seen in the three geographical areas.
Conclusions
The results provide further evidence that educational inequalities in mortality are smaller in the south of Europe than in other European countries.
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References
De Vogli R, Gimeno D, Kivimaki M (2008) Socioeconomic inequalities in health in 22 European countries. N Engl J Med 359:1290
Eikemo TA, Mackenbach JA (2012) The potential for reduction of health inequalities in Europe (EURO GBD SE). Final report. University Medical Center, Rotterdam
Eurostat (2014) Life expectancy by age, sex and educational attainment (ISCED 1997). http://ec.europa.eu/eurostat/en/web/products-datasets/-/DEMO_MLEXPECEDU. Accessed 31 Jan 2014
Federico B, Mackenbach JP, Eikemo TA, Sebastiani G, Marinacci C, Costa G et al (2013) Educational inequalities in mortality in northern, mid and southern Italy and the contribution of smoking. J Epidemiol Community Health 67:603–609
Greenland S, Rothman KJ (1998) Introduction to stratified analysis. In: Rothman KJ, Greenland S (eds) Modern epidemiology. Lippincott Williams and Wilkins, Philadelphia, pp 253–280
Huisman M, Kunst AE, Andersen O, Bopp M, Borgan JK, Borrell C et al (2004) Socioeconomic inequalities in mortality among the elderly in eleven European populations. J Epidemiol Community Health 58:468–475
Huisman M, Kunst E, Bopp M, Borgan JK, Borrell C, Costa G et al (2005) Educational inequalities in cause-specific mortality in middle-aged and older men and women in eight western European populations. Lancet 365:493–500
Kulhánová I, Bacigalupe A, Eikemo TA, Borrell C, Regidor E, Esnaola S et al (2014a) Why does Spain have smaller inequalities in mortality? An exploration of potential explanations. Eur J Public Health 24:370–377
Kulhánová I, Hoffmann R, Eikemo TA, Menvielle G, Mackenbach JP (2014b) Educational inequalities in mortality by cause of death: first national data for the Netherlands. Int J Public Health 59:687–696
Mackenbach JP, Stirbu I, Roskam AJR, Schaap MM, Menvielle G, Leinsalu M et al (2008) Socioeconomic inequalities in health in 22 European countries. N Engl J Med 358:2468–2481
Mackenbach JP, Kulhánová I, Menvielle G, Bopp M, Borrell C, Costa G et al (2014) Trends in inequalities in premature mortality: a study of 3.2 million deaths in 13 European countries. J Epidemiol Community Health 69:207–217
Marinacci C, Grippo F, Pappagallo M, Sebastiani G, Demaria M, Vittori P et al (2013) Social inequalities in total and cause-specific mortality of a sample of the Italian population, from 1999 to 2007. Eur J Public Health 23:582–587
Regidor E, Barrio G, Bravo MJ, de la Fuente L (2014) Has health in Spain been declining since the economic crisis? J Epidemiol Community Health 68:280–282
Reques L, Giráldez-García C, Miqueleiz E, Belza MJ, Regidor E (2014) Educational differences in mortality and the relative importance of different causes of death: a 7-year follow-up study of Spanish adults. J Epidemiol Community Health 68:1151–1160
Toch-Marquardt M, Menvielle G, Eikemo TA, Kulhánová I, Kulik MC, Bopp M et al (2014) Occupational class inequalities in all-cause and cause-specific mortality among middle-aged men in 14 European populations during the early 2000s. PLoS One 30(9):e108072
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Regidor, E., Reques, L., Belza, M.J. et al. Education and mortality in Spain: a national study supports local findings. Int J Public Health 61, 139–145 (2016). https://doi.org/10.1007/s00038-015-0762-z
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DOI: https://doi.org/10.1007/s00038-015-0762-z