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Educational inequalities in avoidable mortality in Europe


Stirbu, I; Kunst, A E; Bopp, M; Leinsalu, M; Regidor, E; Esnaola, S; Costa, G; Martikainen, P; Borrell, C; Kalediene, R; Rychtarikova, J; Artnik, B; Deboosere, P; Mackenbach, J P (2010). Educational inequalities in avoidable mortality in Europe. Journal of Epidemiology & Community Health, 64(10):913-920.

Abstract

BACKGROUND: We compared the magnitude of educational inequalities in mortality avoidable by medical care in 16 European populations and determined the contribution of inequalities in avoidable mortality to educational inequalities in life expectancy in Europe. METHODS: We obtained mortality data for people aged 30-64 years. For each country, the association between level of education and avoidable mortality was measured with the use of regression-based inequality indexes. Life table analysis was used to calculate the contribution of avoidable causes of death to inequalities in life expectancy between lower and higher educated groups. RESULTS: Educational inequalities in avoidable mortality were present in all countries of Europe and in all types of avoidable causes of death. Especially large educational inequalities were found for infectious diseases and conditions that require acute care in all countries of Europe. Inequalities were larger in Central Eastern European (CEE) and Baltic countries, followed by Northern and Western European countries, and smallest in the Southern European regions. This geographic pattern was present in almost all types of avoidable causes of death. Avoidable mortality contributed between 11 and 24% to the inequalities in Partial Life Expectancy between higher and lower educated groups. Infectious diseases and cardio-respiratory conditions were main contributors to this difference. CONCLUSION: Inequalities in avoidable mortality were present in all European countries, but were especially pronounced in CEE and Baltic countries. These educational inequalities point to an important role of healthcare services in reducing inequalities in health.

BACKGROUND: We compared the magnitude of educational inequalities in mortality avoidable by medical care in 16 European populations and determined the contribution of inequalities in avoidable mortality to educational inequalities in life expectancy in Europe. METHODS: We obtained mortality data for people aged 30-64 years. For each country, the association between level of education and avoidable mortality was measured with the use of regression-based inequality indexes. Life table analysis was used to calculate the contribution of avoidable causes of death to inequalities in life expectancy between lower and higher educated groups. RESULTS: Educational inequalities in avoidable mortality were present in all countries of Europe and in all types of avoidable causes of death. Especially large educational inequalities were found for infectious diseases and conditions that require acute care in all countries of Europe. Inequalities were larger in Central Eastern European (CEE) and Baltic countries, followed by Northern and Western European countries, and smallest in the Southern European regions. This geographic pattern was present in almost all types of avoidable causes of death. Avoidable mortality contributed between 11 and 24% to the inequalities in Partial Life Expectancy between higher and lower educated groups. Infectious diseases and cardio-respiratory conditions were main contributors to this difference. CONCLUSION: Inequalities in avoidable mortality were present in all European countries, but were especially pronounced in CEE and Baltic countries. These educational inequalities point to an important role of healthcare services in reducing inequalities in health.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2010
Deposited On:10 Feb 2010 15:06
Last Modified:05 Apr 2016 13:44
Publisher:BMJ Publishing Group
ISSN:0143-005X
Publisher DOI:https://doi.org/10.1136/jech.2008.081737
PubMed ID:19833607
Permanent URL: https://doi.org/10.5167/uzh-27285

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