Educational Disparities in Mortality Between Adults Aged 50-64 and 66-79 Years, U.S

Introduction: This study estimated differences in educational disparities in mortality between ages 50-64 and 66-79 years in the U.S. and explored factors contributing to the differences.

Methods: Based on the follow-up of a nationally representative cohort in the National Longitudinal Mortality Study 2002-2011, relative differences in educational disparities (relative index of inequality) between people aged 50-64 and 66-79 years were calculated for deaths from all causes, cancer, cardiovascular disease, injuries, and other causes by sex and race/ethnicity. Analyses were conducted in 2016.

Results: In all racial/ethnic-, sex-, and age-specific groups, death rates were higher among the least educated than the most educated groups for all causes combined and most specific causes except for injuries in non-Hispanic blacks. Among non-Hispanic whites, the relative index of inequality for all causes combined among the younger and older age groups was 5.6 (95% CI=4.9, 6.5) and 2.8 (95% CI=2.6, 3.0), respectively. Among non-Hispanic blacks, corresponding index values were 4.1 (95% CI=3.6, 4.6) and 1.7 (95% CI=1.6, 1.8). Larger disparities in the younger age group were also observed for cardiovascular disease, cancer, and other causes among non-Hispanic whites, non-Hispanic blacks, and all races combined.

Conclusions: Educational disparities in mortality among non-Hispanic whites and blacks were 41%-61% lower in people aged 66-79 years than in those aged 50-64 years. Various factors may contribute to diminished disparities in the elderly, including differences in access to care, health perception, stress level, lifestyle, and health behaviors with advancing age and retirement.