Educational differentials in U.S. adult mortality : trends and causes
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As life expectancy at birth in the United States approaches eighty years of age, educational differentials in adult mortality are greater than ever. One of the key sociological insights of our time is that these two processes are fundamentally interrelated. As society gains greater social capacity to control health and disease socioeconomic status (SES) becomes increasingly important for shaping healthy social environments and lifestyles, which reduce the risk of mortality. Of all SES indicators, educational attainment is perhaps the single most important predictor of mortality in the United States. Not only do low-educated Americans have shorter lifespans compared to their college-educated counterparts, on average, but they have recently suffered absolute declines in life expectancy. However, debates surrounding the extent, causes, and even validity of those trends continue. This dissertation makes several unique contributions to our understanding of lifespan inequality by educational attainment in the United States. First, using vital statistics data, it documents trends in life expectancy and lifespan variation—a unique dimension of lifespan inequality—by educational attainment for black and white Americans of both genders from 1990 to 2010. Second, it decomposes those trends by age and cause of death in order to understand the proximate causes of the educational disparity in adult mortality. Third, it evaluates the extent to which changes in the composition of education groups account for the rising education-mortality gradient. The findings reveal that the gap in life expectancy at age 25 between the low educated (having fewer than twelve years of schooling) and the college educated has doubled among men and more than tripled among women over the study period; that life expectancy declined among low-educated white men and women (by 0.6 and 3.1 years, respectively); and that much of these trends is attributed to an increase in premature deaths from smoking-related diseases and external causes. While both sides of the selection-causation debate have merit, changes in group composition do not fully account for the increase in mortality among low-educated Americans, for whom economic circumstances have worsened. Overall, the association between educational attainment and adult mortality is pervasive, enduring, and increasing in magnitude.