Educational Differences in Risk of All-Cause Mortality After Acute Cardiovascular Events: Examining Cohort and Gender Variations.

Abstract

Acute cardiovascular events are prevalent in older adults. In this study, following a sample of respondents from the 1996-2016 Health and Retirement Study after diagnosis of myocardial infarction or stroke, we used discrete-time event history models to study mortality post diagnosis. We found an educational gradient in mortality following myocardial infarction or stroke with the better educated surviving longer, even as the gradient was weaker for stroke. Cohort variations existed with the educational gradients stronger for more recent cohorts (Silent and Boomer) as compared with the GI cohort. Gender interacted with cohort to shape mortality such that men from the Silent and Boomer cohorts benefited the most from high school and some college education. Mediation analysis showed that the educational differences in mortality are accounted for by spousal educational attainment, wealth, Medicaid coverage, change in health behaviors, and comorbidities.