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Life
expectancy rises for the educated; the
less-educated reap no benefit
Newswise — It’s no
secret that over the last few decades, life
expectancy in the United States has been
rising. However, recent data shows that not
everyone has benefited from this encouraging
trend.
New findings from
Harvard Medical School and Harvard
University demonstrate that individuals with
more than 12 years of education have
significantly longer life expectancy than
those who never went beyond high school.
“We like to think that
as we as a country get healthier, everyone
benefits,” says David Cutler, dean for
social sciences at the Faculty of Arts and
Sciences at Harvard University, and study
co-author. “Here we’ve found that you can
have a rising tide that only lifts half the
boats—and the ones lifted are the ones doing
better to begin with.”
The research, which was
conducted by Cutler and Ellen Meara,
assistant professor of health care policy at
Harvard Medical School, appears in the
March/April edition of the journal Health
Affairs.
Over the years, much
attention has been paid to mortality rates
based on socio-economic status, but less
attention has been paid to recent trends in
life expectancy, mortality, and education
level.
To understand recent
mortality trends, Meara and Cutler combined
death certificate data with census
population estimates and data from the
National Longitudinal Mortality Study.
Restricting analyses to whites and
non-Hispanic blacks, the team created two
separate data sets, one covering 1981-1988,
and the other 1990-2000.
In both data sets, life
expectancy rose for individuals who had more
than 12 years of education. For those with
12 years or less, it plateaued.
For example, comparing
the 1980s to the 1990s, better educated
individuals experienced nearly a year and a
half of increased life expectancy, while the
less educated experienced only half a year.
For 1990-2000, life expectancy rose an
additional 1.6 years for better educated,
while remaining fixed for the less educated.
In addition, when the
data was broken down by gender, the
researchers found that women fared worse
than men. Less educated women, regardless of
race, experienced a slight decline in life
expectancy at age 25.
Overall in the groups
studied, as of 2000, better educated at age
25 could expect to live to age 82; for less
educated, 75.
“Although improvements
in health often occur more rapidly within
some groups than others, it is surprising
that life expectancy remained so flat for
the less educated during periods when others
enjoyed dramatic gains in longevity,” says
Meara.
The researchers found
that much of the mortality gap can be
attributed to smoking related illnesses.
Just two diseases usually caused by smoking,
lung cancer and chronic obstructive
pulmonary disorder (which comprises chronic
bronchitis and emphysema), account for 20
percent of growing mortality differences in
the 1990s. Many other illnesses like heart
disease and other types of cancer, also
count smoking as contributing factors.
The importance of
smoking is not surprising, since other data
has shown that the less educated have not
given up smoking to the same extent that
those with more education have. (Other
causes of death examined were diseases of
the heart, non-lung cancers, stroke, and
unintentional injuries.)
“There’s a bit of
complacency in the fact that year after year
lifespan goes up,” says Cutler. “Our data
shows us that we need to start thinking
about doing much more for the groups at the
bottom if we don’t want to see these gaps
grow.”
This research was
funded by the National Institute on Aging
and the National Institute on Drug Abuse.
Full Citation:
Health Affairs,
March/April 2008, Volume 27, Number 2
“The Gap Gets Bigger:
Changes in Mortality and Life Expectancy, by
Education, 1981-2000”
Ellen Meara(1), Seth
Richards(2), and David Cutler(3)
1-Department of Health
Care Policy, Harvard Medical School, Boston,
MA
2-University of Pennsylvania, Philadelphia,
PA
3-Department of Economics, Harvard
University, Cambridge, MA
Harvard Medical School
(http://hms.harvard.edu/hms/home.asp) has
more than 7,500 full-time faculty working in
11 academic departments located at the
School's Boston campus or in one of 47
hospital-based clinical departments at 17
Harvard-affiliated teaching hospitals and
research institutes.
Those affiliates
include Beth Israel Deaconess Medical
Center, Brigham and Women's Hospital,
Cambridge Health Alliance, Children's
Hospital Boston, Dana-Farber Cancer
Institute, Forsyth Institute, Harvard
Pilgrim Health Care, Joslin Diabetes Center,
Judge Baker Children's Center, Immune
Disease Institute, Massachusetts Eye and Ear
Infirmary, Massachusetts General Hospital,
McLean Hospital, Mount Auburn Hospital,
Schepens Eye Research Institute, Spaulding
Rehabilitation Hospital, and VA Boston
Healthcare System.
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