Educational Differences in U.S. Adult Mortality

TLDR

The study applied hierarchical cross‑classified random‑effects models to jointly estimate age, period, and cohort effects on all‑cause and cause‑specific mortality among non‑Hispanic white and black adults with varying education levels from 1986 to 2006. Results show that declines in mortality were driven entirely by cohort changes, with widening educational gaps in all‑cause, heart disease, and lung cancer mortality, while disparities in unpreventable cancer mortality remained unchanged, highlighting the importance of a cohort perspective.

Abstract

We use hierarchical cross-classified random-effects models to simultaneously measure age, period, and cohort patterns of mortality risk between 1986 and 2006 for non-Hispanic white and non-Hispanic black men and women with less than a high school education, a high school education, and more than a high school education. We examine all-cause mortality risk and mortality risk from heart disease, lung cancer, and unpreventable cancers. Findings reveal that temporal reductions in black and white men's and women's mortality rates were driven entirely by cohort changes in mortality. Findings also demonstrate that disparate cohort effects between education groups widened the education gap in all-cause mortality risk and mortality risk from heart disease and lung cancer across this time period. Educational disparities in mortality risk from unpreventable cancers, however, did not change. This research uncovers widening educational differences in adult mortality and demonstrates that a cohort perspective provides valuable insights for understanding recent temporal changes in U.S. mortality risk.