More variation in lifespan in lower educated groups: evidence from 10 European countries

Background Whereas it is well established that people with a lower socio-economic position have a shorter average lifespan, it is less clear what the variability surrounding these averages is. We set out to examine whether lower educated groups face greater variation in lifespans in addition to having a shorter life expectancy, in order to identify entry points for policies to reduce the impact of socio-economic position on mortality. Methods We used harmonized, census-based mortality data from 10 European countries to construct life tables by sex and educational level (low, medium, high). Variation in lifespan was measured by the standard deviation conditional upon survival to age 35 years. We also decomposed differences between educational groups in lifespan variation by age and cause of death. Results Lifespan variation was higher among the lower educated in every country, but more so among men and in Eastern Europe. Although there was an inverse relationship between average life expectancy and its standard deviation, the first did not completely predict the latter. Greater lifespan variation in lower educated groups was largely driven by conditions causing death at younger ages, such as injuries and neoplasms. Conclusions Lower educated individuals not only have shorter life expectancies, but also face greater uncertainty about the age at which they will die. More priority should be given to efforts to reduce the risk of an early death among the lower educated, e.g. by strengthening protective policies within and outside the health-care system

Lifespan variation by occupational class: compression or stagnation over time

Cross-sectional analyses of adult lifespan variation have found an inverse association between socioeconomic position and lifespan variation, but the trends by social class are unknown. We investigated trends in lifespan variation over four decades (1971–2010) by occupational social class (manual, lower nonmanual, upper nonmanual, other) using Finnish register data. We performed age and cause-of-death decompositions of lifespan variation for each sex (a) by occupational class over time and (b) between occupational classes at a shared level of life expectancy. Although life expectancy increased in all classes, lifespan variation was stable among manual workers and decreased only among nonmanual classes. These differences were caused by early-adult mortality: older-age lifespan variation declined for all the classes, but variation in early-adult mortality increased for all classes except the highest. The manual class’s high and stagnant lifespan variation was driven by declines in circulatory diseases that were equally spread over early mortality-compressing and older mortality-expanding ages, as well as by high early-adult mortality from external causes. Results were similar for men and women. The results of this study, which is the first to document trends in lifespan variation by social class, suggest that mortality compression is compatible with increasing life expectancy but currently achieved only by higher occupational classes

Mortality Modeling

Mortality models approximate mortality patterns or dynamics over age and time. An age pattern of mortality can be any mathematical function of mortality, such as rates, probabilities, survivorship, or death distributions. Such functions may be modeled in the form of a life table or a simplified function with some parameters. Mortality models in general fall into three main categories: (i) models designed to help understand regularities in mortality patterns and dynamics, for example where population-level mortality patterns are modeled as an emergent property of dynamics at the individual level, (ii) those that aim to predict mortality patterns, for example for purposes of pension provisions, and (iii) those aimed at mortality measurement for purposes of mortality and health monitoring. In the following, mortality modeling refers to models of mortality measurement at the population level