The Contributions of Diseases to Increasing Educational Mortality Differential in Austria

Abstract

This paper examines how much changing educational disparity for specific causes of death contributed to the change in overall educational mortality disparity between 1981/82 and 1991/92 among Austrian adults aged 30–74 years. Besides specific causes of death, the study also examines educational differentials for both avoidable causes of death and mortality amenable to medical intervention. The data source is based on a one-year mortality follow-up of the total Austrian census population. The data for the examined population is made up of individual records for people aged 30–74, totaling 3,805,208 for 1981/82 and 4,064,184 for 1991/92, from which 34,218 and 29,443, respectively, were on deceased persons. The study uses a new approach for decomposing the change in overall mortality differentials into contributions of specific causes to the change. For this purpose, it extends the regression-based Slope Index of Inequality. The findings suggest that educational inequalities in overall mortality have widened significantly in Austria, but more among men than among women. However, without the increase in the disparity for ischemic heart disease, between 1981/82 and 1991/92, there would have been a decline in absolute educational disparity in overall mortality among Austrian men and women. Also striking are the rising absolute and relative disparities for diabetes among females as well as the increasing disparities for colorectal cancer and digestive diseases among men. Increasing differentials in avoidable mortality essentially contributed to increased educational disparities in overall mortality. With regard to mortality amenable to medical treatment, the differentials increased considerably for men but not for women.