Educational inequalities in mortality in the Netherlands

Ivana Kulhánová, Erasmus Medical Centre, Rotterdam
Rasmus Hoffmann, Erasmus Medical Centre, Rotterdam
Terje A. Eikemo, Erasmus Medical Centre, Rotterdam
Johan P. Mackenbach, Erasmus Medical Centre, Rotterdam

Social inequalities in health are substantial in most European countries. The reduction of these inequalities is a major challenge for public health. Interest in researching social inequalities in health is increasing. In the Netherlands, however, the scarcity of data sources has led the magnitude of these inequalities to be neglected. We linked the registries of deaths (1998-2007) with the Dutch Labour Force Surveys (1998-2002). We focused on adult population aged 30 years and more at the baseline. We used educational attainment as a measure of socioeconomic position. The final dataset contained 345267 individuals, including 14697 deaths. The magnitude of educational differences in mortality was estimated by means of the Cox proportional hazard model. Furthermore, we calculated age-standardized mortality rates by education and cause of death, and life expectancy at age of 30 years. We applied the technique of life expectancy decomposition in order to obtain cause-specific contributions to the difference between the least and the most educated people. This opened new opportunities to research social variations in mortality in the Netherlands.