Educational Inequalities in Cause-Specific Mortality in Spain: Analysis Using Multiple Causes of Death

Sergi Trias-Llimós , London School of Hygiene & Tropical Medicine
Amand Blanes, Centre d'Estudis Demogràfics
Jeroen J. A. Spijker, Centre d’Estudis Demogràfics (CED), UAB

Background: Health inequalities in mortality persist in European countries and reducing them is one of the main public health policy priorities. We study the educational gradient in cause-specific mortality, with special attention to life-style related causes of death by making use of multiple causes of death. Methods: We use individual detailed mortality data, which includes educational attainment and all causes mentioned in the death certificate, for the population aged 30+ living in Spain in 2016-17. We use multiple causes of death (MCOD) to study alcohol-related and drug-related mortality. We estimate cause-specific mortality by age and educational attainment, and we examine educational gradient in cause-specific mortality using Poisson regression models. Results: Educational inequalities in cause-specific mortality exist in Spain, particularly from major causes such are cardiovascular or respiratory. In addition, population groups with lower educational attainment present higher risks of mortality from lifestyle-related causes such as alcohol- or drug-related causes (higher mortality rate ratios as compared to main causes of death). Conclusions: The preliminary results from this study highlight the importance of amenable causes of death related with lifestyle factors on overall mortality inequalities in Spain. In the full paper, we will also provide a detailed assessment by age groups and the inclusion of additional causes of death (e.g. smoking, hypertension) to explore both absolute and relative inequalities in mortality.

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 Presented in Session 19. Causes of Death and Morbidity