Rising educational gradients in mortality: the role of behavioral risk factors

J Health Econ. 2011 Dec;30(6):1174-87. doi: 10.1016/j.jhealeco.2011.06.009. Epub 2011 Sep 3.


The long-standing inverse relationship between education and mortality strengthened substantially at the end of the 20th century. This paper examines the reasons for this increase. We show that behavioral risk factors are not of primary importance. Smoking declined more for the better educated, but not enough to explain the trend. Obesity rose at similar rates across education groups, and control of blood pressure and cholesterol increased fairly uniformly as well. Rather, our results show that the mortality returns to risk factors, and conditional on risk factors, the return to education, have grown over time.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Blood Pressure
  • Body Mass Index
  • Cholesterol / blood
  • Cross-Sectional Studies
  • Educational Status*
  • Health Status Disparities
  • Humans
  • Hypertension / blood
  • Hypertension / epidemiology
  • Life Style*
  • Middle Aged
  • Mortality / trends*
  • Obesity / epidemiology*
  • Risk Factors
  • Smoking / adverse effects
  • Smoking / epidemiology*
  • Socioeconomic Factors
  • United States / epidemiology


  • Cholesterol