Educational inequalities and premature mortality: the Cuba Prospective Study

Ross, Stephanie; Rojas, Nurys B. Armas; Sawatzky, Julia; Varona-Pérez, Patricia; Burrett, Julie Ann; Martínez, Migdalia Miranda; Lorenzo-Vázquez, Elba; Constantén, Sonia Bess; Sherliker, Paul; Rigau, José Manuel Morales; López, Osvaldo Jesús Hernández; Morales, Miguel Ángel Martínez; Alomá, Ismell Alonso; Estupiñán, Fernando Achiong; González, Mayda Díaz; Muñoz, Noel Rosquete; Asencio, Marelis Cendra; Emberson, Jonathan; Pető, Richárd; Lewington, Sarah; Lacey, Ben

doi:10.1016/s2468-2667(22)00237-7

Cited by 7 publications

(5 citation statements)

References 43 publications

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“…The cause to which education has the strongest impact is closely tied to the epidemiological profile of a country. In other countries, 9 , 10 , 11 such as Cuba, education was found to exert a more substantial impact on vascular mortality in women and cancer mortality in men. In Mexico, education demonstrated a larger influence on renal/acute diabetes mortality in both sexes.…”

Section: Discussionmentioning

confidence: 91%

“… 29 Stephanie Ross et al. 10 also found that the death risk of population with the lowest education level was 1.79 times that of those with the highest education, and the effect among women was more pronounced. Gianfranco 28 et al.…”

Section: Discussionmentioning

confidence: 98%

“…Many research have highlighted the salient relationship between education and health outcomes including life expectancy, healthy aging, cardio-cerebrovascular health, cancer as well as exposure to risk factors such as obesity, substance abuse, and lifestyle factors. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 In recent years, several large-scale cohort studies 9 , 10 , 11 , 12 , 13 , 14 have demonstrated the impact of education on all-cause and cause-specific mortality at the population level. Although there is a consistent negative association between education and all-cause, as well as cause-specific mortality, the magnitude of this association varies across countries depending on the epidemiological profiles and risk factors trends.…”

Section: Introductionmentioning

confidence: 99%

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The association between education and premature mortality in the Chinese population: a 10-year cohort study

Wang,

Zhao,

Yang

et al. 2024

The Lancet Regional Health - Western Pacific

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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The association between education and premature mortality in the Chinese population: a 10-year cohort study

Wang,

Zhao,

Yang

et al. 2024

The Lancet Regional Health - Western Pacific

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“…Our findings align with studies finding a mortality gradient in educational attainment or IQ. 13,16,19 Especially related is a study from the US finding that the state-level income-mortality gradient could be fully accounted for by the differences in shares of inhabitants with completed high school education. 14 Documenting the role of school performance, and that it accounts for the family social economic gradient in young adult death, is in itself important because it identifies a group at a particularly high risk.…”

Section: Discussionmentioning

confidence: 99%

“…10,11 Other studies point to the importance of educational attainment for understanding mortality. 4,[12][13][14][15][16] While the gradient in mortality across family background and educational attainment is well established, there are no large-scale investigations of their relative importance. Moreover, the role of indicators observable earlier in life, such as school performance at age 16, is largely unexplored.…”

Section: Introductionmentioning

confidence: 99%

School performance and mortality in young adulthood: a register-based population study

Reme

Torvik

2023

Preprint

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Background: The social gradient in mortality among young adults is well-documented, but poorly understood. This study contrasts the role of parental income and education versus own school performance as predictors of early death. Methods: We estimated the prospective association between grade point average from lower secondary education and mortality between age 16 and 30 for the Norwegian birth cohorts 1985-2002 (N = 986,573). This association was compared to the associations between measures of family socioeconomic status and young adult mortality in the offspring. We also estimated hazard ratios in models including both school performance, parental income, and education. Sibling comparison analyses were also estimated to assess the importance of within-family variation. Last, we used the cause of death register to estimate the hazard ratio of different causes of death among individuals with poor school performance. Findings: During the observational period, we observed 1300 deaths in the lowest quartile of school performance (0.06%) and 413 deaths in the highest quartile of school performance (0.02%). The risk of early death among boys in the lowest quartile of school performance compared to the highest quartile was larger for boys [HR = 3.68, 95% CI 3.54-3.81] than for girls [HR = 2.82, 95% CI 2.62-3.01]. The corresponding hazard ratios across parental income quartiles were 1.79 [95% CI 1.67-1.1.91] for boys, and 1.63 [95% CI 1.43-1.82] for girls. Across parental education level, the hazard ratio was 2.03 [95% CI 1.85-2.21] for boys, and 1.64 [95% CI 1.35-1.93] for girls. When jointly including school performance, parental income and education in the same model, parental income and education were insignificant, while the association school performance remained strong: HR = 3.57 [95% CI 3.44-3.71] for boys, and 2.98 [95% CI 2.78-3.18] for girls. With regards to causes of death, the highest hazard ratio among those in the lowest quartile of school performance was for drug-related poisoning, with 6.47 [95% CI 2.78-3.18] for boys and 7.3 [95% CI 4.93-10.80] for girls. The results were consistent in sibling comparison analyses. Interpretation: School performance is a substantially stronger predictor of early death than common measures of socioeconomic background. School performance absorbs the social gradient in early death.

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Educational inequalities and premature mortality: the Cuba Prospective Study

Cited by 7 publications

References 43 publications

The association between education and premature mortality in the Chinese population: a 10-year cohort study

The association between education and premature mortality in the Chinese population: a 10-year cohort study

School performance and mortality in young adulthood: a register-based population study

Association of social determinants, lifestyle, and metabolic factors with mortality in Chinese adults: A nationwide 10-year prospective cohort study

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