Friday, September 7, 2012

Impact of education and occupation on life expectancy

USA

According to a 2011 study by the Centers for Disease Control and Prevention in the U.S., the gap in life expectancy at age 25, by education, actually widened between 1996 and 2006 for both men and women with a bachelor’s degree or higher.


The less educated are living in a time warp (source)

UK  

Why accountants live longer than builders


The Telegraph, 25 Oct 2007 (source)




Middle-class professionals such as doctors and accountants are outliving builders and cleaners by as much as eight years, according to official figures.
People from all social classes are living longer, data from the Office for National Statistics showed yesterday, but variations in the age at which people are dying indicate Government measures to reduce the gap between rich and poor have failed.
The study looked at people from five social classes in 1972-76 and 2002-05.

Skilled workers have had a greater increase in life expectancy at birth and at the age of 65 than those in manual occupations, the researchers found.

Men in professional occupations can expect to live to 80, almost eight years longer than those in unskilled jobs, whose life expectancy is 72.7.

Professional women have a life expectancy at birth of 85.1 years, compared with 78.1 for manual workers.
Men in managerial and technical occupations such as journalists and teachers have slightly shorter life expectancy at 79.4, while unskilled workers such as labourers and cleaners have the shortest life expectancy.
The King's Fund, a health think tank, said the figures showed the differences between social groups were growing.
Karen Jochelson, a research fellow, said: "Those who have a lower life expectancy have it because of a range of factors.
"They may live in housing which is damp and has poor heating, or near busy roads which means more air pollution.
"But the nature of people's jobs also has an effect. If you have autonomy and control over what you do, you tend to be in better health.
"There is also evidence that shows people on low incomes have higher smoking rates and their diets tend to be worse because high fat, high sugar diets are cheaper."
Andrew Lansley, the shadow health secretary, said: "If we are going to tackle poor health outcomes in the most deprived areas and among the poorest sections of society, we must ensure that public health resources and the actions of government are focused on this and not simply the treatment of disease."
Other experts said there would be problems if the poor failed to catch up with the rich. The less affluent started to give up smoking in the 1970s, two decades later than their richer neighbours, and the health improvements seen by this change take about 30 years to materialise.
"If we don't start seeing changes as a result of this, then there are other factors at play," said Danny Dorling, professor of human geography at Sheffield University.
One factor is that the rich can effectively buy longer lives through more regular holidays and leisure activities.

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Whitehall Studies (source)

The original Whitehall Study investigated social determinants of health, specifically the cardiorespiratory disease prevalence and mortality rates among British male civil servants between the ages of 20 and 64. The initial prospective cohort study, the Whitehall I Study, examined over 18,000 male civil servants, and was conducted over a period of ten years, beginning in 1967. A second cohort study, the Whitehall II Study, examined the health of 10,308 civil servants aged 35 to 55, of whom two thirds were men and one third women. A long-term follow-up of study subjects from the first two phases is ongoing.
 
The Whitehall cohort studies found a strong association between grade levels of civil servant employment and mortality rates from a range of causes. Men in the lowest grade (messengers, doorkeepers, etc.) had a mortality rate three times higher than that of men in the highest grade (administrators).
By design, the Whitehall studies have been focused upon a single set of related occupations, where the people within each occupational grade tend to be socially similar, yet clear social distinctions between grades are inherent. The studies were designed in this manner as an attempt to avoid certain research drawbacks associated with generalized social class groupings—drawbacks that otherwise would result from the diversity of occupations within social classes—which in turn would tend to reduce the objectivity of any analysis.

The primary health risks under investigation in the Whitehall studies include cardiovascular function, smoking, car ownership, angina, leisure and hobbies, ECG measurements, and diabetes.

High blood pressure at work was associated with greater "job stress," including "lack of skill utilization," "tension," and "lack of clarity" in tasks assigned. The higher blood pressure among the lowest grade servants was found to be related to the highest job stress score, whereas blood pressure at home was not related to job stress level.

According to Whitehall study researchers, "a steep inverse association between social class, as assessed by grade of employment, and mortality from a wide range of diseases" has been demonstrated. Summing up the moral of the Whitehall studies, the researchers concluded that "more attention should be paid to the social environments, job design, and the consequences of income inequality".

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Europe

Source: Eurostat Statistics in Focus (here)


Life expectancy by educational attainment is a very important indicator of socio-economic inequalities in health. Based on the available data for a selection of EU Member States and Norway, a systematic relationship between educational attainment and mortality can be observed: at any age, life expectancy is less among persons with the lowest educational attainment and increases with educational level.

Large differences in life expectancy by educational attainment can be observed among Member States. Moreover, these differences are more pronounced for men than for women.

Country names are abbreviated as follows: Bulgaria (BG), Czech Republic (CZ), Denmark (DK), Estonia (EE), Italy (IT), Hungary (HU), Malta (MT), Poland (PL), Romania (RO), Slovenia (SI), Finland (FI), Sweden (SE), and Norway (NO).

Glossary

Life expectancy at age x: is the average number of years a person would live beyond age x if current age specific mortality rates were to remain the same.

Educational attainment (highest level of education successfully completed):

Statistics are compiled using the International Standard Classification of Education (ISCED), version 1997, as follows

• Low corresponds to pre-primary, primary and lower secondary education (ISCED levels 0, 1, 2);
• Medium corresponds to upper secondary and post-secondary non-tertiary education (ISCED levels 3 and 4);
• High corresponds to tertiary education (ISCED levels 5 and 6).

Educational attainment level is used in this publication as a proxy for socio-economic status.






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South Korea
 
Social inequalities in life expectancy during the transition period 
of economic crisis (1995-2005) in Korea  
 

Youngtae Cho
School of Public Health, Seoul National University, Seoul, Korea. 

 
Abstract    
Objectives: To examine social inequalities in life expectancy during the transition period of the Korean economic crisis.    
Methods: Data from the census and national deaths in the National Statistics Office in Korea. 
Life expectancy estimates were calculated by age, gender, and educational attainment for three time periods: 1994-1997, 1998-2001, 2002-2005. Absolute differences in life expectancy by educational attainment were utilized as a proxy measure of social inequality. 
Findings: Those with less education experienced a shorter life expectancy at each age than their counterparts with higher levels of education attainment. At age 30, university-educated men experienced life expectancy 15.4 years (1994-1997), 17.9 years (1998-2001) and 19.2 years (2002-2005) higher than those elementary or less-educated counterparts did. For women, the corresponding differences by each period were 8.8 years, 10.0 years and 18.8 years. Widening social inequalities in life expectancy are evident during the transitional period of the Korean financial economic crisis, 1994-2005.  
   
Conclusions: This study evinces that the widening gap of social inequalities in life expectancy is closely related to the widening gap of social inequalities in Korea following a macroeconomic crisis.  

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Extract (source)
 

Table 1 features life expectancies by the level of education for men, women, and all 
Koreans among three different time points. Across all three time points, the level of 
education 
considerably increases life expectancy for all age intervals, although some exceptions exist. 
In the first time point, life expectancy at age 30 for those who graduated from elementary 
school, middle school, high school, and university were 42.8, 43.9, 45.0, and 48.5 years for 
all Koreans, respectively. The corresponding figures in the second and third time points also 
gradually increases as the level of education increases. Consistent patterns were observed 
even when men and women were independently examined. Exceptions were found for the 
elderly population (aged about 50 or greater) between elementary and middle school 
graduates in the first and the second time points in that the life expectancy of the elementary 
school graduates were slightly higher than those of the middle school graduates. This 
exception was not observed in the latest time point. These findings suggest that the gradient 
effect of education on life expectancy become much clearer after the economic crisis. 


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Table 2 is derived from Table 1.  "Univ-Elemen" = (the value for "Univ") - (the value for "Elemen") in Table 1.
 



Table 2 presents the differences in life expectancy between university and or up and 
other levels of education. At younger ages, the life expectancy gap between those university 
graduated or up and those elementary school graduated or less grows during the later time 
points (5.7 years in 1994-1997, 8.7 years in 1998-2001, and 11.6 years in 2002-2005) among 
all Koreans. Thus, the gap approximately doubled during the past ten years. Worsening life 
expectancy differentials between the highest and the lowest education level was observable 
for all subsequent age groups. In the comparison between those high school graduated and 
those university graduated or up at age 30, however, the gap in life expectancy decreased 
from 3.5 years in the first time point to 2.8 years in the last time point. This pattern of a
narrowing gap was observed for all age intervals. Accordingly, one may posit that the 
economic crisis has resulted in some small positive contributions to Korean society in terms 
of life expectancy since the gap between the highest and the second highest education levels 
became narrower. However, it is much more likely that the economic crises had differential 
effects by education and it is very certain that the crisis has had a large negative impact on the 
life of the least educated Koreans. 

When men and women are separately considered, more interesting findings were 
observed. For men, the differences in life expectancy and their changing patterns for the last 
decade were about the same as what observed for all Koreans. That is, the inequality has 
increased between the highest and the lowest educational groups, but decreased between the 
first and second highest groups. However for women, the inequality has gradually increased 
for all education groups in that university graduated women at age 30 outlive their high 
school graduated counterparts by 3.4 years in the first time point, and 3.8 years in the last 
time point. This pattern was consistent throughout all age intervals. Further, the disadvantage 
in life expectancy of the least educated Koreans women, relative to the highest educated 
counterparts, has more than doubled during the ten years in almost all age intervals. Note that 
men experienced an average of 50% increase in life expectancy advantage over time. These 
results clearly suggest that the adverse effect of economic crisis was much greater for women 
and the less educated than for men and the highly educated.

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