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Association of Education Level, Race and Cause of Death

By August 29, 2019Commentary

A fundamental measure of health outcomes in a society is life expectancy and mortality.  Astoundingly, in the US life expectancy declined by .3 years from 2014 to 2017.  Some of this is due to drug use and suicide, but some broader trends may also be at work.  Researchers writing in the Journal of the American Medical Association looked at associations between level of education and other factors and cause of death from 2010 to 2017, using standard data sets.   (JAMA Article)   Historically, there has been a large gap in life expectancy, as much as 5 to 10 years, between those who did not even get a high school education and those who completed college.  There appears to be a syndrome of poor behaviors that relate not just to education but to health, work, financial matters and other important life activities.  Of the study population, 48% were male and 52% female; 85% was white (which apparently includes hispanics and Asians) and 15% African-American.  43% were in a low-education group that had not completed high school, 24% were a middle group that had gone to college but not gotten a degree and 34% had at least a four-year degree.

Life expectancy at age 25 declined from 79.34 years to 79.15 years between 2010 and 2017.  The decline was entirely among white men and women, with no change for black men and an increase for African-American women.  Among white men, life expectancy in the low and middle education groups declined by almost a full year, while increasing over half a year in the high education group.  A similar pattern was observed among white women.  Black men with a low education status saw a decrease of life expectancy of about a quarter of a year, with no change in the other education status groups. Black women experienced an increase in life expectancy across all educational groups.  While circulatory diseases, cancer and smoking-related diseases were responsible for the most years of life lost during the study period, the amount lost to circulatory diseases declined modestly  during the period among all racial sub-groups.  There was a more significant decline in years lost to smoking, particularly among men.  Years lost to drug and alcohol use and suicide increased significantly across all racial and sex sub-groups.  Drug and alcohol use were particular problems, especially for white men.  Years lost to cancer and smoking declined in all education groups, while those lost to drug use increased.  Increases in lost years were greater, however in the low and middle education groups.  For low-educated black men, deaths due to firearms also caused a substantial rise in lost years of life.  And the difference in years of life lost between educational groups grew during the study period.  Given that the study period is relatively short, this is an alarming large change in life expectancy.

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