Can taking educational
levels into account give
us a clearer picture as to
why there’s a persistent
socioeconomic gap in
U.S. mortality rates?
Wealth and Health
There is ample evidence in scientific literature
documenting differences in health outcomes
by socioeconomic status and suggesting that
those with a higher socioeconomic status have
better health outcomes and tend to live longer.
The evidence of a direct relationship between
socioeconomic status and health is consistent
across all three of the most common measures:
income, education, and occupation.
Health inequalities observed in old age are the
result of competing forces acting over the life cycle.
On the one hand, health differentials experienced
in early life and adulthood shape the health status
of those who eventually will reach old age. There’s
evidence, for instance, that there are significant
differences in the prevalence of mortality-related
diseases among those who are middle-aged but not
among the elderly. This suggests that individuals
who face potentially fatal conditions in midlife often don’t make it to old age. Those who do reach old
age represent a highly selective group with regard to
both their health and their sociodemographic characteristics. On the other hand, the fact that more and
more people are surviving to older ages suggests that
they increasingly are overcoming adversities that
previously might have shortened their lives.
This raises the question: Among people who
already have reached the age of 65, what roles do socioeconomic status and activity limitations play in
mortality and survivorship?
and level of education
Numerous studies show an inverse association between education and mortality in the United States:
People with higher levels of education tend to have
lower mortality rates.
This gap in mortality has persisted even in the
face of the general decline in mortality rates since
the 1960s. In fact, the gap seems to be increasing.
Between 1960 and the mid-1980s, for example, the
decline in mortality was faster among people with
higher levels of education.
New evidence shows further expansion in the
mortality gap in recent years. In the 20-year period
between 1986 and 2006, there was a steeper increase
in the mortality gap at older ages by level of education for both men and women. While mortality rates
declined over the period across all levels of education
among men, those with a college education benefited
the most. Among women there were divergent trends
in mortality by level of education, both of which led
to an expansion of the gap in mortality based on socioeconomic status. Women with a college education
had a decline in mortality, while those who didn’t
complete high school showed an increase.
There’s an interaction between level of education and limitations in activity in old age that leads
to important differences in survivorship. A study
published in 2001 in Social Science & Medicine found
that for 30-year-old men and women (both black and
white) in 1990 there was at least a 10-year difference