Social dimensions of mortality from external causes in Lithuania: do education and place of residence matter?

Abstract

To assess inequalities in mortality from external causes by the level of education and the place of residence during the period of socio-economic transition in Lithuania. Information on deaths, place of residence, and the level of education of persons aged 25 and older was derived from the National Database of Lithuania and censuses for 1989 (n=3537) and 2001 (n=4790). Mortality from external causes of Lithuanian urban and rural populations was strongly associated with the level of education. Educational inequalities increased throughout the period of socio-economic transition. In urban areas, mortality among the least educated population was 3.20 times higher in 1989 and 3.37 times higher in 2001, compared to those with university-level education. In rural areas the educational mortality rate ratios reached 3.47 and 4.33, respectively. The greatest educational inequalities were observed in suicide mortality, especially among males. The results of this study disclosed increasing inequalities in mortality from external causes. Less educated populations, especially in rural areas, should receive particular attention in the development of strategies for the prevention of mortality from external causes.