International Journal of Epidemiology, Vol 28, 58-63, Copyright © 1999 by International Epidemiological Association
C Borrell, E Regidor, LC Arias, P Navarro, R Puigpinos, V Dominguez and A Plasencia
BACKGROUND: In Spain, studies on social inequalities in mortality based on
individuals are few due to the poor quality of information on occupation in
death certificates. This study looks at the differences in mortality
according to educational level, using individual information obtained
through the linkage between the Death Register and the Municipal Census, in
the cities of Madrid and Barcelona, Spain. METHODS: The study populations
were residents of Madrid and Barcelona aged >24 years, who died in 1993
and 1994. Indicators obtained for each city and educational level were:
age- and sex-specific mortality rates, and life expectancy at 25 years.
Poisson regression models were fitted to obtain the relative risk (RR) of
death for each educational level with respect to the reference level
(higher education completed), adjusted for age. RESULTS: The mortality rate
was lower among individuals with higher educational levels, while life
expectancy at 25 years was higher. In both cities men and women with no
education showed the highest mortality in all age groups, with very high RR
in the youngest age group (RR for men aged 25-34 years = 7.08 in Madrid and
6.02 in Barcelona, whereas in women these RR were 6.33 and 5.63
respectively). In Barcelona the greater part of the overall mortality
difference for the group aged 25-34 years was due to AIDS (acquired
deficiency syndrome, 33.4% in men and 59.3% in women). CONCLUSION: The
present study has found higher mortality (mainly from AIDS) among
individuals with no academic qualifications thus drawing attention to the
need to implement policies aimed at reducing these inequalities.
ARTICLES
Inequalities in mortality according to educational level in two large Southern European cities
Municipal Institute of Health, Barcelona, Spain.
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