Volume 10 - Article 1 | Pages 1–26
Educational differentials in male mortality in Russia and northern Europe: A comparison of an epidemiological cohort from Moscow and St. Petersburg with the male populations of Helsinki and Oslo
By Vladimir Shkolnikov, Alexander D. Deev, Øystein Kravdal, Tapani Valkonen
Abstract
Background:
Prior estimates of the Russian mortality by socio-demographic group revealed significant differentials around the censuses of 1979 and 1989, but these studies were based on different sources of information on education for the deceased and the population at risk, leading to a potential numerator-denominator bias. To eliminate this problem, and to compare with the corresponding differentials in Nordic countries, an epidemiological cohort from Moscow and St. Petersburg is used for estimation of mortality in this study, along with similar register-based data from Helsinki and Oslo.
Data and Methods:
The Russian data include 7815 men from Moscow and St. Petersburg born in 1916-35 who participated in the Lipid Research Clinics (LRC) program, with a follow-up period from 1975 to 1997. Data with a similar structure, covering complete cohorts, were established for men born 1916-35 cohorts and living in Helsinki (1976-1995) or Oslo (1975-1991). Three educational categories were used: low (less than 10 years of schooling), middle (11 to 12 years) and high (13+ years).
Results:
In the LRC cohort, mortality of men with high education is close to the city average for Helsinki and Oslo. Absolute inter-group differences are much greater in the Russian sample than in the two other populations. Differences in temporary life expectancies (40-74) between men with high and low education are 5.2, 3.5, and 3.2 years in the LRC cohort, Helsinki, and Oslo, respectively. Also relative differences are larger in the LRC cohort, although less markedly. Low/high education ratios of standardized death rates are 2.2, 2.0, and 1.9 in the three populations.
Educational mortality differences measured by a relative index of inequality are 3.1, 2.7, and 2.6 (using the all-Russia educational distribution in the calculation for the LRC cohort.) A similar pattern appears, of course, in Poisson regression models where it is controlled not only for age, but also calendar time. Consideration of causes of death shows that the larger relative difference between educational categories in the LRC cohort than in the Nordic capitals stems from particularly sharp gradients in mortality from cerebrovascular diseases and, more clearly, external causes.
Whereas all-cause mortality has increased over time for men in the LRC cohort with low or middle education, there are indications that those with high education have experienced a decline (i.e. differentials have increased). In contrast to this, the development in Oslo and Helsinki has been more similar for the different educational groups.
Implications:
The educational gaps in mortality of the Russian population and its extreme levels in the low education group should be addressed by adequate health policies. Trends in inequalities in health and their determinants require careful monitoring and further analyses.
Author's Affiliation
- Vladimir Shkolnikov - Max-Planck-Institut für Demografische Forschung, Germany EMAIL
- Alexander D. Deev - National Research Center for Preventive Medicine, Russian Federation EMAIL
- Øystein Kravdal - Universitetet i Oslo, Norway EMAIL
- Tapani Valkonen - Helsingin Yliopisto (University of Helsinki), Finland EMAIL
Other articles by the same author/authors in Demographic Research
Two-dimensional contour decomposition: Decomposing mortality differences into initial difference and trend components by age and cause of death
Volume 50 - Article 41
The influence of parental cancer on the mental health of children and young adults: Evidence from Norwegian register data on healthcare consultations
Volume 50 - Article 27
Are sibling models a suitable tool in analyses of how reproductive factors affect child mortality?
Volume 42 - Article 28
Taking birth year into account when analysing effects of maternal age on child health and other outcomes: The value of a multilevel-multiprocess model compared to a sibling model
Volume 40 - Article 43
The increasing mortality advantage of the married: The role played by education
Volume 38 - Article 20
Socio-economic determinants of divorce in Lithuania: Evidence from register-based census-linked data
Volume 33 - Article 30
Components and possible determinants of decrease in Russian mortality in 2004-2010
Volume 28 - Article 32
What has high fertility got to do with the low birth weight problem in Africa?
Volume 28 - Article 25
Further evidence of community education effects on fertility in sub-Saharan Africa
Volume 27 - Article 22
Children's stunting in sub-Saharan Africa: Is there an externality effect of high fertility?
Volume 25 - Article 18
Demographers’ interest in fertility trends and determinants in developed countries: Is it warranted?
Volume 22 - Article 22
The effects of socioeconomic and cultural characteristics of regions on the spatial patterns of the Second Demographic Transition in Finland
Volume 19 - Article 61
Does income inequality really influence individual mortality?: Results from a ‘fixed-effects analysis’ where constant unobserved municipality characteristics are controlled
Volume 18 - Article 7
Effects of current education on second- and third-birth rates among Norwegian women and men born in 1964: Substantive interpretations and methodological issues
Volume 17 - Article 9
Characteristics of urban regions and all-cause mortality in working-age population: Effects of social environment and interactions with individual unemployment
Volume 17 - Article 5
Does cancer affect the divorce rate?
Volume 16 - Article 15
A simulation-based assessment of the bias produced when using averages from small DHS clusters as contextual variables in multilevel models
Volume 15 - Article 1
Estimates of mortality and population changes in England and Wales over the two World Wars
Volume 13 - Article 16
Official population statistics and the Human Mortality Database estimates of populations aged 80+ in Germany and nine other European countries
Volume 13 - Article 14
Introduction to the Special Collection “Human Mortality over Age, Time, Sex, and Place:
The 1st HMD Symposium”
Volume 13 - Article 10
Geographical diversity of cause-of-death patterns and trends in Russia
Volume 12 - Article 13
A summary of Special Collection 2: Determinants of Diverging Trends in Mortality
Volume 10 - Article 12
The problematic estimation of "imitation effects" in multilevel models
Volume 9 - Article 2
Gini coefficient as a life table function: Computation from discrete data, decomposition of differences and empirical examples
Volume 8 - Article 11
The impact of individual and aggregate unemployment on fertility in Norway
Volume 6 - Article 10
Is the Previously Reported Increase in Second- and Higher-order Birth Rates in Norway and Sweden from the mid-1970s Real or a Result of Inadequate Estimation Methods?
Volume 6 - Article 9
Life expectancy in two Caucasian countries. How much due to overestimated population?
Volume 5 - Article 7
The High Fertility of College Educated Women in Norway: An Artefact of the Separate Modelling of Each Parity Transition
Volume 5 - Article 6
A search for aggregate-level effects of education on fertility, using data from Zimbabwe
Volume 3 - Article 3
An Illustration of the Problems Caused by Incomplete Education Histories in Fertility Analyses
Special Collection 3 - Article 6
Increasing excess mortality among non-married elderly people in developed countries
Special Collection 2 - Article 12
Monitoring of trends in socioeconomic inequalities in mortality: Experiences from a European project
Special Collection 2 - Article 9
Russian mortality beyond vital statistics: Effects of social status and behaviours on deaths from circulatory disease and external causes - a case-control study of men aged 20-55 years in Urdmurtia, 1998-99
Special Collection 2 - Article 4
Introduction to the Special Collection of papers on "Determinants of diverging trends in mortality"
Special Collection 2 - Article 1
Most recent similar articles in Demographic Research
Excess mortality associated with HIV: Survey estimates from the PHIA project
Volume 51 - Article 38
| Keywords:
excess mortality,
HIV/AIDS,
mortality
Is single parenthood increasingly an experience of less-educated mothers? A European comparison over five decades
Volume 51 - Article 34
| Keywords:
age,
children,
cross-national comparison,
education,
Europe,
family life course,
inequality,
single motherhood
A Bayesian model for age at death with cohort effects
Volume 51 - Article 33
| Keywords:
age at death,
Bayesian approach,
cohort effects,
Italy,
mortality
On the relationship between life expectancy, modal age at death, and the threshold age of the life table entropy
Volume 51 - Article 24
| Keywords:
Gompertz law,
life expectancy,
lifespan variation,
longevity,
mode,
mortality
The role of sex and age in seasonal mortality – the case of Poland
Volume 51 - Article 17
| Keywords:
mortality,
Poland,
seasonality,
sex differences
Download to Citation Manager
PubMed
Google Scholar