Measuring Recent Apparent Declines In Longevity: The Role Of Increasing Educational Attainment

Abstract

Independent researchers reported an alarming decline in life expectancy after 1990 among US non-Hispanic whites with less than a high school education. However, US educational attainment rose dramatically over the twentieth century; thus, focusing on changes in mortality rates of those not completing high school means looking at a different, shrinking, and increasingly vulnerable segment of the population in each year. We analyzed US data to examine the robustness of earlier findings to categorizing education in terms of relative rank in the overall distribution of each birth cohort, instead of by credentials such as high school graduation. Estimating trends in mortality for the bottom quartile, we found little evidence that survival probabilities declined dramatically. We conclude that widely publicized estimates of worsening mortality rates among whites with low socioeconomic position are highly sensitive to how educational attainment is classified. However, whites with low socioeconomic position, especially women, are not sharing in improving life expectancy, and disparities between US blacks and whites are entrenched. Findings underscore the urgency of an agenda to equitably disseminate new medical technologies and to deepen knowledge of social determinants of health and how it can be applied to promote the objective of achieving population health equity.

Trends in Education-Specific Life Expectancy, Data Quality, and Shifting Education Distributions: A Note on Recent Research

“…The reason is compositional change, which is the tendency for the same education category to represent a lower segment of the SES spectrum for younger cohorts than for older cohorts (Hendi 2015). Compositional change has been a focus of recent research on trends in educational gradients in life expectancy (Bound et al 2015; Dowd and Hamoudi 2014; Hendi 2015), and it is clear it can also influence lifespan variation. The category “high school graduate” makes up a smaller component of each successive birth cohort, leaving a smaller and more select group at the younger ages and a larger and less-select group at the older ages.…”

Physical Functioning Trends among US Women and Men Age 45–64 by Education Level

“…Finally, the average educational attainment of the target population increased significantly between 2000 and 2016, so the relative sizes and compositions of the educational groups changed. In particular, the lower-educated groups are more negatively selected and the higher-educated groups less positively selected, so nonrandom selection could play a role in the group-specific trends (Bound et al 2015). However, we re-estimated all models using period-specific relative educational rank instead of standard educational categories (results available on request) and reached the same substantive conclusions: worsening functioning among most working-age Americans, with steeper increases in problems among the more disadvantaged.…”

Are Functional and Activity Limitations Becoming More Prevalent among 55 to 69-Year-Olds in the United States?

“…The proportion with a high school education is projected to decline from 31 to 27% and the proportion with a bachelor’s degree or more to increase from 31 to 35% over the same period. Of course, the implications for health of belonging to a particular education group may well change over time [10]. …”

“…A recent National Research Council report (2015) [9] and Bound and colleagues (2015) [10] highlighted growing socioeconomic differentials in life expectancy in the United States. The review of literature by Hummer and Hernandez (2013) [11] suggests that health behaviors such as smoking, nutrition, and physical activity account for about 30 percent of the educational difference in survival.…”