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The Nonlinear Relationship Between Education and Mortality: An Examination of Cohort, Race/Ethnic, and Gender Differences

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Abstract

Researchers investigating the relationship between education and mortality in industrialized countries have consistently shown that higher levels of education are associated with decreased mortality risk. The shape of the education–mortality relationship and how it varies by demographic group have been examined less frequently. Using the U.S. National Health Interview Survey-Linked Mortality Files, which link the 1986 through 2004 NHIS to the National Death Index through 2006, we examine the shape of the education–mortality curve by cohort, race/ethnicity, and gender. Whereas traditional regression models assume a constrained functional form for the dependence of education and mortality, in most cases semiparametric models allow us to more accurately describe how the association varies by cohort, both between and within race/ethnic and gender subpopulations. Notably, we find significant changes over time in both the shape and the magnitude of the education–mortality gradient across cohorts of women and white men, but little change among younger cohorts of black men. Such insights into demographic patterns in education and mortality can ultimately help increase life expectancies.

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Notes

  1. We also estimated Cox proportional hazard models with penalized spline on the education term with both accelerated failure Weibull distributions and accelerated failure logged distributions. These two specifications, however, yielded very poor model fit and are therefore excluded from the results presented in the paper.

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Acknowledgments

This article was supported by Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) research (R01 HD053696) and infrastructure (R24 HD066613) grants, and by NICHD and Office of Research on Women’s health (ORWH) grant number K12HD055892. We thank the National Center for Health Statistics (NCHS) for collecting and assembling the data and generously making them available to the research public; Nancy Mann for expert editorial assistance; and the anonymous reviewers for insightful and helpful comments. The content of this manuscript is the sole responsibility of the authors and does not necessarily represent the official views of NIH, NICHD, or NCHS.

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Authors and Affiliations

  1. Department of Sociology, University of Illinois-Chicago, 4112 BSB, 1007 West Harrison Street, Chicago, IL, 60607-7140, USA

    Bethany G. Everett

  2. Division of General Medical Disciplines, Stanford University School of Medicine, 265 Welch Road, Stanford, CA, 94305, USA

    David H. Rehkopf

  3. Department of Sociology and Population Program, Institute of Behavioral Science, University of Colorado-Boulder, 483 UCB, Boulder, CO, 80309-0483, USA

    Richard G. Rogers

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  1. Bethany G. Everett
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Correspondence to Bethany G. Everett.

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Everett, B.G., Rehkopf, D.H. & Rogers, R.G. The Nonlinear Relationship Between Education and Mortality: An Examination of Cohort, Race/Ethnic, and Gender Differences. Popul Res Policy Rev 32, 893–917 (2013). https://doi.org/10.1007/s11113-013-9299-0

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