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The online version of this article (https://doi.org/10.1007/s13524-018-0718-z) contains supplementary material, which is available to authorized users.
For a long time, studies of socioeconomic gradients in health have limited their attention to between-group comparisons. Yet, ignoring the differences that might exist within groups and focusing on group-specific life expectancy levels and trends alone, one might arrive at overly simplistic conclusions. Using data from the Spanish Encuesta Sociodemográfica and recently released mortality files by the Spanish Statistical Office (INE), this is the first study to simultaneously document (1) the gradient in life expectancy by educational attainment groups, and (2) the inequality in age-at-death distributions within and across those groups for the period between 1960 and 2015 in Spain. Our findings suggest that life expectancy has been increasing for all education groups but particularly among the highly educated. We observe diverging trends in life expectancy, with the differences between the low- and highly educated becoming increasingly large, particularly among men. Concomitantly with increasing disparities across groups, length-of-life inequality has decreased for the population as a whole and for most education groups, and the contribution of the between-group component of inequality to overall inequality has been extremely small. Even if between-group inequality has increased over time, its contribution has been too small to have sizable effects on overall inequality. In addition, our results suggest that education expansion and declining within-group variability might have been the main drivers of overall lifespan inequality reductions. Nevertheless, the diverging trends in longevity and lifespan inequality across education groups represent an important phenomenon whose underlying causes and potential implications should be investigated in detail.
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Bongaarts, J. (2005). Long-range trends in adult mortality: Models and projection methods. Demography, 42, 23–49. CrossRef
Bongaarts, J., & Feeney, G. (2003). Estimating mean lifetime. Proceedings of the National Academy of Sciences, 100, 13127–13133. CrossRef
Borrell, C., & Arias, A. (1995). Socioeconomic factors and mortality in urban settings: The case of Barcelona, Spain. Journal of Epidemiology and Community Health, 49, 460–465. CrossRef
Borrell, C., Marí-Dell’Olmo, M., Serral, G., Martínez-Beneito, M., Gotsens, M., & MEDEA Members. (2010). Inequalities in mortality in small areas of eleven Spanish cities (The multicenter MEDEA project). Health & Place, 16, 703–711. CrossRef
Borrell, C., Plasencia, A., Pasarin, I., & Ortún, V. (1997). Widening social inequalities in mortality: The case of Barcelona, a southern European city. Journal of Epidemiology and Community Health, 51, 659–667. CrossRef
Borrell, C., Regidor, E., Arias, L.-C., Navarro, P., Puigpinós, R., Domínguez, V., & Plasencia, A. (1999). Inequalities in mortality according to educational level in two large Southern European cities. International Journal of Epidemiology, 28, 58–63. CrossRef
Brass, W. (1971). On the scale of mortality. In W. Brass (Ed.), Biological aspects of demography (pp. 69–110). London, UK: Taylor & Francis.
Brass, W., & Hill, K. H. (1973, August). Estimating adult mortality from orphanhood. Paper presented at the International Population Conference IUSSP, Liège, Belgium.
Breen, R., & Andersen, S. H. (2012). Educational assortative mating and income inequality in Denmark. Demography, 49, 867–887. CrossRef
Breen, R., & Salazar, L. (2011). Educational assortative mating and earnings inequality in the United States. American Journal of Sociology, 117, 808–843. CrossRef
Brown, D. C., Hayward, M. D., Montez, J. K., Hummer, R. A., Chiu, C.-T., & Hidajat, M. M. (2012). The significance of education for mortality compression in the United States. Demography, 49, 819–840. CrossRef
Canudas-Romo, V. (2008). The modal age at death and the shifting mortality hypothesis. Demographic Research, 19(article 30), 1179–1204. https://doi.org/10.4054/DemRes.2008.19.30
Case, A., & Deaton, A. (2015). Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proceedings of the National Academy of Sciences, 112, 15078–15083. CrossRef
Chetty, R., Stepner, M., Abraham, S., Lin, S., Scuderi, B., Turner, N., . . . Cutler, D. (2016). The association between income and life expectancy in the United States, 2001–2014. JAMA, 315, 1750–1766.
Cheung, S. L. K., Robine, J.-M., Tu, E. J.-C., & Caselli, G. (2005). Three dimensions of the survival curve: Horizontalization, verticalization, and longevity extension. Demography, 42, 243–258. CrossRef
Davey Smith, G., Blane, D., & Bartley, M. (1994). Explanations for socio-economic differentials in mortality. European Journal of Public Health, 4, 131–144. CrossRef
Davey Smith, G., Hart, C., Hole, D., MacKinnon, P., Gillis, C., Watt, G., . . . Hawthorne, V. (1998). Education and occupational social class: Which is the more important indicator of mortality risk? Journal of Epidemiology and Community Health, 52, 153–160.
Deboosere, P., Gadeyne, S., & Van Oyen, H. (2009). The 1991–2004 evolution in life expectancy by educational level in belgium based on linked census and population register data. European Journal of Population, 25, 175–196. CrossRef
Duleep, H. O. (1989). Measuring socioeconomic mortality differentials over time. Demography, 26, 345–351. CrossRef
Edwards, R. D. (2013). The cost of uncertain life span. Journal of Population Economics, 26, 1485–1522. CrossRef
Edwards, R. D., & Tuljapurkar, S. (2005). Inequality in life spans and a new perspective on mortality convergence across industrialized countries. Population and Development Review, 31, 645–674. CrossRef
Elo, I. T., & Preston, S. H. (1996). Educational differentials in mortality: United States, 1979–1985. Social Science & Medicine, 42, 47–57. CrossRef
Engelman, M., Canudas-Romo, V., & Agree, E. M. (2010). The implications of increased survivorship for mortality variation in aging populations. Population and Development Review, 36, 511–539. CrossRef
Esnaola, S., Aldasoro, E., Ruiz, R., Audicana, C., Pérez, Y., & Calvo, M. (2006). Desigualdades socioeconómicas en la mortalidad en la Comunidad Autónoma del País Vasco [Socioeconomic inequalities in mortality in the Basque Country (Spain)]. Gaceta Sanitaria, 20, 16–24. CrossRef
Esteve, A., Spijker, J., Riffe, T., & García, J. (2012). Spousal and parental roles among female student populations in 55 low-and middle-income countries. Vienna Yearbook of Population Research, 10, 77–94. CrossRef
Feldman, J. J., Makuc, D. M., Kleinman, J. C., & Cornoni-Huntley, J. (1989). National trends in educational differentials in mortality. American Journal of Epidemiology, 129, 919–933. CrossRef
Fries, J. F. (1980). Aging, natural death, and the compression of morbidity. New England Journal of Medicine, 303, 130–135. CrossRef
Gillespie, D. O., Trotter, M. V., & Tuljapurkar, S. D. (2014). Divergence in age patterns of mortality change drives international divergence in lifespan inequality. Demography, 51, 1003–1017. CrossRef
Hendi, A. S. (2017). Trends in education-specific life expectancy, data quality, and shifting education distributions: A note on recent research. Demography, 54, 1203–1213. CrossRef
Huisman, M., Kunst, A. E., Andersen, O., Bopp, M., Borgan, J.-K., Borrell, C.,... Donkin, A. (2004). Socioeconomic inequalities in mortality among elderly people in 11 European populations. Journal of Epidemiology and Community Health, 58, 468–475.
Huisman, M., Kunst, A. E., Bopp, M., Borgan, J.-K., Borrell, C., Costa, G.,... Marinacci, C. (2005a). Educational inequalities in cause-specific mortality in middle-aged and older men and women in eight western European populations. Lancet, 365, 493–500.
Huisman, M., Kunst, A. E., & Mackenbach, J. P. (2005b). Educational inequalities in smoking among men and women aged 16 years and older in 11 European countries. Tobacco Control, 14, 106–113. CrossRef
Hummer, R. A., & Lariscy, J. T. (2011). Educational attainment and adult mortality. In R. G. Rogers & E. M. Crimmins (Eds.), International handbook of adult mortality (pp. 241–261). Dordrecht, the Netherlands: Springer. CrossRef
INE. (2016). Estadística de defunciones. Asignación de nivel educativo a ficheros de defunciones de 2015. Método de obtención y advertencias a usuarios [Death statistics. Assignment of educational level to the 2015 death files. Obtaining method and warnings to users] . Madrid, Spain: INE (Instituto Nacional de Estadistica). Retrieved from http://www.ine.es/metodologia/t20/t2030306_niveduc.pdf
KC, S., & Lentzner, H. (2010). The effect of education on adult mortality and disability: A global perspective. Vienna Yearbook of Population Research, 8, 201–235. CrossRef
Kitagawa, E. M., & Hauser, P. M. (1973). Differential mortality in the United States: A study in socioeconomic epidemiology. Cambridge, MA: Harvard University Press. CrossRef
Kulhánová, I., Bacigalupe, A., Eikemo, T. A., Borrell, C., Regidor, E., Esnaola, S., & Mackenbach, J. P. (2014). Why does Spain have smaller inequalities in mortality? An exploration of potential explanations. European Journal of Public Health, 24, 370–377. CrossRef
Kunst, A. E. (1997). Cross-national comparisons of socio-economic differences in mortality (Doctoral Dissertation). University Medical Center, Erasmus University Rotterdam, Rotterdam, the Netherlands.
Kunst, A. E., Bos, V., Andersen, O., Cardano, M., Costa, G., Harding, S., . . . Reid, A. (2004). Monitoring of trends in socioeconomic inequalities in mortality: Experiences from a European project. Demographic Research, 2(article 9), 229–254. https://doi.org/10.4054/DemRes.2004.S2.9
Luy, M. (2012). Estimating mortality differences in developed countries from survey information on maternal and paternal orphanhood. Demography, 49, 607–627. CrossRef
Luy, M., Di Giulio, P., & Caselli, G. (2011). Differences in life expectancy by education and occupation in Italy, 1980–94: Indirect estimates from maternal and paternal orphanhood. Population Studies, 65, 137–155. CrossRef
Mackenbach, J. P. (2012). The persistence of health inequalities in modern welfare states: The explanation of a paradox. Social Science & Medicine, 75, 761–769. CrossRef
Mackenbach, J. P., Bos, V., Andersen, O., Cardano, M., Costa, G., Harding, S., . . . Kunst, A. (2003). Widening socioeconomic inequalities in mortality in six Western European countries. International Journal of Epidemiology, 32, 830–837.
Mackenbach, J. P., Kulhánová, I., Artnik, B., Bopp, M., Borrell, C., Clemens, T.,... Lundberg, O. (2016). Changes in mortality inequalities over two decades: Register based study of European countries. BMJ, 353, i1732. https://doi.org/10.1136/bmj.i1732
Mackenbach, J. P., Stirbu, I., Roskam, A. J., Schaap, M. M., Menvielle, G., Leinsalu, M., & Kunst, A. E. (2008). Socioeconomic inequalities in health in 22 European countries. New England Journal of Medicine, 358, 2468–2481. CrossRef
Majer, I. M., Nusselder, W., Mackenbach, J., & Kunst, A. (2011). Socioeconomic inequalities in life and health expectancies around official retirement age in 10 Western-European countries. Journal of Epidemiology and Community Health, 65, 972–979. CrossRef
Marmot, M., Allen, J., Bell, R., & Goldblatt, P. (2012). Building of the global movement for health equity: From Santiago to Rio and beyond. Lancet, 379, 181–188. CrossRef
Marmot, M. G., & McDowall, M. E. (1986). Mortality decline and widening social inequalities. Lancet, 328, 274–276. CrossRef
Marmot, M. G., & Shipley, M. J. (1996). Do socioeconomic differences in mortality persist after retirement? 25 year follow up of civil servants from the first Whitehall study. BMJ, 313, 1177–1180. CrossRef
Masquelier, B. (2013). Adult mortality from sibling survival data: A reappraisal of selection biases. Demography, 50, 207–228. CrossRef
Molla, M. T., Madans, J. H., & Wagener, D. K. (2004). Differentials in adult mortality and activity limitation by years of education in the United States at the end of the 1990s. Population and Development Review, 30, 625–646. CrossRef
Mookherjee, D., & Shorrocks, A. (1982). A decomposition analysis of the trend in UK income inequality. Economic Journal, 92, 886–902. CrossRef
Murtin, F., Mackenbach, J., Jasilionis, D., & d’Ercole, M. M. (2017). Inequalities in longevity by education in OECD countries (1815–2031). Paris, France: OECD. Retrieved from https://doi.org/10.1787/6b64d9cf-en
Nau, C., & Firebaugh, G. (2012). A new method for determining why length of life is more unequal in some populations than in others. Demography, 49, 1207–1230. CrossRef
Palloni, A., Massagli, M., & Marcotte, J. (1984). Estimating adult mortality with maternal orphanhood data: Analysis of sensitivity of the techniques. Population Studies, 38, 255–279. CrossRef
Pappas, G., Queen, S., Hadden, W., & Fisher, G. (1993). The increasing disparity in mortality between socioeconomic groups in the United States, 1960 and 1986. New England Journal of Medicine, 329, 103–109. CrossRef
Permanyer, I., García, J., & Esteve, A. (2013). The impact of educational homogamy on isolated illiteracy levels. Demography, 50, 2209–2225. CrossRef
Pincus, T., & Callahan, L. F. (1994). Associations of low formal education level and poor health status: Behavioral, in addition to demographic and medical, explanations? Journal of Clinical Epidemiology, 47, 355–361. CrossRef
Puigpinós, R., Borrell, C., Antunes, J. L. F., Azlor, E., Pasarín, M. I., Serral, G., . . . Fernández, E. (2009). Trends in socioeconomic inequalities in cancer mortality in Barcelona: 1992–2003. BMC Public Health, 9, 35. https://doi.org/10.1186/1471-2458-9-35
Regidor, E., Gutiérrez-Fisac, J. L., & Rodríguez, C. (1995). Increased socioeconomic differences in mortality in eight Spanish provinces. Social Science & Medicine, 41, 801–807. CrossRef
Rentería, E., & Spijker, J. (2017, April). Half a century of education inequalities in adult mortality in Spain: An approach using survey data on parents’ survivorship. Poster presented at the Annual Meeting of the Population Association of America, Chicago, IL.
Rentería, E., & Turra, C. M. (2009, September–October). Measuring educational differences in mortality among women living in highly unequal societies with defective data: The case of Brazil. Paper presented at the International Population Conference IUSSP, Marrakesh, Morocco.
Reques, L., Giráldez-García, C., Miqueleiz, E., Belza, M. J., & Regidor, E. (2014). Educational differences in mortality and the relative importance of different causes of death: A 7-year follow-up study of Spanish adults. Journal of Epidemiology and Community Health, 68, 1151–1160. CrossRef
Rogot, E., Sorlie, P. D., & Johnson, N. J. (1992). Life expectancy by employment status, income, and education in the National Longitudinal Mortality Study. Public Health Reports, 107, 457–461.
Ross, C. E., & Wu, C.-l. (1995). The links between education and health. American Sociological Review, 60, 719–745. CrossRef
Sasson, I. (2016a). Diverging trends in cause-specific mortality and life years lost by educational attainment: Evidence from United States Vital Statistics Data, 1990–2010. PLoS One, 11, e0163412. https://doi.org/10.1371/journal.pone.0163412 CrossRef
Sasson, I. (2016b). Trends in life expectancy and lifespan variation by educational attainment: United States, 1990–2010. Demography, 53, 269–293. CrossRef
Sasson, I. (2017). Reply to Trends in education-specific life expectancy, data quality, and shifting education distributions: A note on recent research. Demography, 54, 1215–1219. CrossRef
Schiaffino, A., Fernandez, E., Borrell, C., Salto, E., Garcia, M., & Borras, J. M. (2003). Gender and educational differences in smoking initiation rates in Spain from 1948 to 1992. European Journal of Public Health, 13, 56–60. CrossRef
Seligman, B., Greenberg, G., & Tuljapurkar, S. (2016). Equity and length of lifespan are not the same. Proceedings of the National Academy of Sciences, 113, 8420–8423. CrossRef
Smith, J. P. (2004). Unraveling the SES: Health connection. Population and Development Review, 30, 108–132. CrossRef
Smits, J., & Monden, C. (2009). Length of life inequality around the globe. Social Science & Medicine, 68, 1114–1123. CrossRef
Spijker, J. (2004). Socioeconomic determinants of mortality differentials in Europe (Unpublished Doctoral Disertation) . Department of Spatial Sciences, University of Groningen, Groningen, the Netherlands.
Steingrímsdóttir, Ó. A., Næss, Ø., Moe, J. O., Grøholt, E.-K., Thelle, D. S., Strand, B. H., & Bævre, K. (2012). Trends in life expectancy by education in Norway 1961–2009. European Journal of Epidemiology, 27, 163–171. CrossRef
Tarkiainen, L., Martikainen, P., Laaksonen, M., & Valkonen, T. (2012). Trends in life expectancy by income from 1988 to 2007: Decomposition by age and cause of death. Journal of Epidemiology and Community Health, 66, 573–578. CrossRef
Timonin, S., Shkolnikov, V. M., Jasilionis, D., Grigoriev, P., Jdanov, D. A., & Leon, D. A. (2016). Disparities in length of life across developed countries: Measuring and decomposing changes over time within and between country groups. Population Health Metrics, 14, 29. https://doi.org/10.1186/s12963-016-0094-0 CrossRef
United Nations. (1983). Manual X: Indirect techniques for demographic estimations. New York, NY: United Nations Publications.
Van Raalte, A. A., & Caswell, H. (2013). Perturbation analysis of indices of lifespan variability. Demography, 50, 1615–1640. CrossRef
Van Raalte, A. A., Martikainen, P., & Myrskylä, M. (2014). Lifespan variation by occupational class: Compression or stagnation over time? Demography, 51, 73–95. CrossRef
Wardle, J., & Steptoe, A. (2003). Socioeconomic differences in attitudes and beliefs about healthy lifestyles. Journal of Epidemiology & Community Health, 57, 440–443. CrossRef
WHO. (2000). The world health report 2000—Health systems: Improving performance. Geneva, Switzerland: World Health Organization.
Wilmoth, J. R., & Horiuchi, S. (1999). Rectangularization revisited: Variability of age at death within human populations. Demography, 36, 475–495. CrossRef
Winkleby, M. A., Jatulis, D. E., Frank, E., & Fortmann, S. P. (1992). Socioeconomic status and health: How education, income, and occupation contribute to risk factors for cardiovascular disease. American Journal of Public Health, 82, 816–820. CrossRef
Wrycza, T. F., Missov, T. I., & Baudisch, A. (2015). Quantifying the shape of aging. PLoS One, 10, e0119163. https://doi.org/10.1371/journal.pone.0119163 CrossRef
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