Academic journal article Demographic Research

Trends in Educational Mortality Differentials in Austria between 1981/82 and 2001/2002: A Study Based on a Linkage of Census Data and Death Certificates

Academic journal article Demographic Research

Trends in Educational Mortality Differentials in Austria between 1981/82 and 2001/2002: A Study Based on a Linkage of Census Data and Death Certificates

Article excerpt

Abstract

Background-Many studies for European populations found an increase in socio-economic mortality differentials during the last decades of the 20th century, at least in relative terms. The aim of our paper is to explore the situation in Austria, for a wide age range, over a period of 20 years.

Methods-Based on a linkage of census information and death certificates, we computed age and education specific death rates. We calculate life expectancies at age 35 by educational level as well as regression-based measures of absolute (SII) and relative (RII) inequality, for the periods 1981/82, 1991/92, and 2001/2002.

Results-Life expectancy increased faster for the higher educated in the 1980s, whereas this trend reversed in the following decade. For males at working ages an increase in relative mortality differentials was observed during the 1980s. Absolute mortality differentials decreased among elderly females in the 1990s, particularly for circulatory disease mortality. Altogether the educational pattern of mortality was rather stable in Austria at the end of the 20th century.

Conclusions-Compared with results from other countries, trends in educational mortality differentials seem to be rather favorable in Austria in the 1990s. A stable health care system, the healthy migrant effect, and relatively low unemployment rates may have contributed to stable mortality differentials. However, an important explanation is also the inclusion of higher ages in our study.

1. Introduction

The existence of a relationship between socio-economic status (SES) and mortality is nowadays beyond dispute. All available studies on the topic show that people with a higher SES face lower mortality risks, regardless of whether the SES is measured by education, occupation, income, or place of residence (Blakely et al. 2004; Boyle et al. 2004; Cesaroni et al. 2006; Huisman 2004; Kunst 1997; Vallin et al. 2001). This finding holds for both sexes, most causes of death, and all age groups. Even in the age group 75+, beyond premature mortality, significant mortality advantages of the better-off can be observed (Huisman et al. 2005).

Large mortality differentials by SES are also documented for Austria. Doblhammer (1996) reported significant excess mortality of manual workers and people with no further education in the early 1980s, particularly among males at working ages. A very high cause specific social gradient was found for accidents, suicide, and certain types of cancer. Klotz (2007) estimated that at the turn of the 21st century the life expectancy gap at age 35 between the highest and the lowest educational group was 6.2 years for males and 2.8 years for females. International comparisons of European populations in the 1990s suggested for Austria an overproportional educational gradient in stroke mortality (Avendano et al. 2004) and an average educational gradient in ischemic heart disease mortality (Avendano et al. 2006).

For many European populations it was reported that relative socio-economic mortality differentials increased during the 1980s, whereas absolute differentials were rather stable (Huisman 2004; Kunst 1997). The life expectancy gap between the higher and lower social strata widened for instance in England/Wales, Sweden, Finland, or the city of Turin (Vallin et al. 2001). Mackenbach et al. (2003) mention a faster decline in circulatory disease mortality among the non-manual classes as a major explanation for increasing inequality in a series of countries; also alcohol-associated mortality and external causes of death are cited as influential (Mackenbach et al. 2003; Martikainen et al. 2001).

Concerning trends in Europe in the entire 1990s, studies found that the socioeconomic mortality gap was widening further in England/Wales (Davey Smith et al. 2002) and in Denmark (Brønnum-Hansen and Baadsgard 2008). For the city of Rome an increase in relative differentials during the 1990s and a stabilization at the very end of the 20th century was reported (Cesaroni et al. …

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