TY - JOUR
T1 - Educational differentials in mortality from cardiovascular disease among men and women
T2 - The Israel Longitudinal Mortality Study
AU - Manor, Orly
AU - Eisenbach, Zvi
AU - Friedlander, Yechiel
AU - Kark, Jeremy D.
PY - 2004/8
Y1 - 2004/8
N2 - Purpose While socioeconomic inequalities in cardiovascular disease have been observed in most industrialized countries, available information in Israel centers on ethnic variations and the role of education has yet to be investigated. This study examines educational differentials in cardiovascular mortality in Israel for both men and women aged 45 to 69 and 70 to 89 years. Methods Data are based on a linkage of records from a 20% sample of the 1983 census with the records of deaths occurring until the end of 1992. The study population includes 152,150 individuals and the number of cardiovascular deaths was 14,651. Educational differentials were assessed for mortality of diseases of the circulatory system, ischemic heart diseases, cerebrovascular diseases, hypertensive diseases, and sudden death. Results Substantial mortality differentials were found among individuals aged 45 to 69 years, with larger inequalities among women. The age-adjusted relative risk for mortality of cardiovascular diseases among those with elementary education (≤8 years) compared with those with high education (≥13 years) was 1.46 (95% CI: 1.32-1.61) for men and 2.06 (95% CI: 1.76-2.41) for women. Differentials among the elderly were markedly narrower than those for younger adults. Similar trends were observed for mortality of subgroups of causes including cerebrovascular diseases and ischemic heart diseases. Educational differentials were not affected by adjustment for ethnic origin and car ownership. Conclusions Those with 8 years of education or less suffer higher risk of cardiovascular mortality compared with adults with 13 or more years of education. Young, less educated women are more vulnerable, and health and social policies oriented towards this group are needed.
AB - Purpose While socioeconomic inequalities in cardiovascular disease have been observed in most industrialized countries, available information in Israel centers on ethnic variations and the role of education has yet to be investigated. This study examines educational differentials in cardiovascular mortality in Israel for both men and women aged 45 to 69 and 70 to 89 years. Methods Data are based on a linkage of records from a 20% sample of the 1983 census with the records of deaths occurring until the end of 1992. The study population includes 152,150 individuals and the number of cardiovascular deaths was 14,651. Educational differentials were assessed for mortality of diseases of the circulatory system, ischemic heart diseases, cerebrovascular diseases, hypertensive diseases, and sudden death. Results Substantial mortality differentials were found among individuals aged 45 to 69 years, with larger inequalities among women. The age-adjusted relative risk for mortality of cardiovascular diseases among those with elementary education (≤8 years) compared with those with high education (≥13 years) was 1.46 (95% CI: 1.32-1.61) for men and 2.06 (95% CI: 1.76-2.41) for women. Differentials among the elderly were markedly narrower than those for younger adults. Similar trends were observed for mortality of subgroups of causes including cerebrovascular diseases and ischemic heart diseases. Educational differentials were not affected by adjustment for ethnic origin and car ownership. Conclusions Those with 8 years of education or less suffer higher risk of cardiovascular mortality compared with adults with 13 or more years of education. Young, less educated women are more vulnerable, and health and social policies oriented towards this group are needed.
KW - Cardiovascular Disease
KW - cardiovascular disease
KW - cerebrovascular disease
KW - CRVD
KW - CVD
KW - Education
KW - HTD
KW - hypertensive disease
KW - IHD
KW - ischemic heart disease
KW - Mortality
KW - SD
KW - Social Inequalities
KW - sudden death
UR - http://www.scopus.com/inward/record.url?scp=4043150727&partnerID=8YFLogxK
U2 - 10.1016/j.annepidem.2003.10.011
DO - 10.1016/j.annepidem.2003.10.011
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C2 - 15301781
AN - SCOPUS:4043150727
SN - 1047-2797
VL - 14
SP - 453
EP - 460
JO - Annals of Epidemiology
JF - Annals of Epidemiology
IS - 7
ER -