Increasing differential mortality by educational attainment in adults in the United States

Int J Health Serv. 2008;38(1):47-61. doi: 10.2190/HS.38.1.c.


Economic inequality has increased substantially in the United States since the early 1970s. Inequality in mortality increased from 1960 to 1986. To assess the trend in inequality in mortality the authors calculate age-adjusted mortality rates by educational attainment for 2000 and compare them with rates from 1960 and 1986, using relative and absolute indexes of inequality. Rates are calculated for non-Hispanic white and black adults aged 25 to 64 years, using mortality data from U.S. Vital Statistics and population estimates from the Census Public Use Microdata Sample. The trend toward increasing inequality in mortality between 1960 and 1986 accelerated from 1986 to 2000. Improvements in mortality went disproportionately to those with the most education. Mortality rates for whites with low education, which declined from 1960 to 1986, actually rose from 1986 to 2000. The relative change was greatest for those with only a high school education. This change, however, is largely explained by shifts in the distribution of education, which left those with a high school education in a lower position. The increase in inequality was particularly strong in whites and stronger in men than in women. For black men there was a small decline in absolute inequality between 1986 and 2000.

MeSH terms

  • Adult
  • African Americans
  • Educational Status*
  • Female
  • Health Status Disparities*
  • Humans
  • Male
  • Middle Aged
  • Mortality / ethnology
  • Mortality / trends*
  • Poisson Distribution
  • Sex Factors
  • Socioeconomic Factors
  • United States / epidemiology
  • Whites