Abstract
BackgroundCancer mortality in the U.S. has fallen in recent decades; however, individuals with lower levels of education experienced a smaller decline than more highly educated individuals. This analysis aimed to measure the influence of education lower than a high school diploma, on cancer amenable mortality among Non-Hispanic Whites (NHW) and Non-Hispanic Blacks (NHB) in the U.S. from 1989 to 2018.MethodsWe analyzed data from 8.2 million death certificates of men and women who died from cancer between 1989 and 2018. We examined 5-year and calendar period intervals, as well as annual percent changes (APC). APC was adjusted for each combination of sex, educational level, and race categories (8 models) to separate the general trend from the effects of age.ResultsOur study demonstrated an increasing mortality gap between the least and the most educated NHW and NHB males and females who died from all cancers combined and for most other cancer types included in this study. The gap between the least and the most educated was broader among NHW males and females than among NHB males and females, respectively, for most malignancies.ConclusionsIn summary, we reported an increasing gap in the age-adjusted cancer mortality among the most and the least educated NHW and NHB between 25 and 74 years of age. We demonstrated that although NHB exhibited the greatest age-adjusted mortality rates for most cancer locations, the gap between the most and the least educated was shown for NHW.
Highlights
Low education is a strong predictor of high mortality in the United States (U.S.)
We dichotomized the education variable into two groups of less than 12 years of education and 12 years or more of schooling, consistent with previous researchers [30, 31]. This approach was taken since the highest mortality rates were reported among those with less than 12 years of schooling [32, 33], suggesting that not completing a high school education was a critical threshold for the risk of mortality in the U.S attaining a high school diploma is an important step in decreasing yearly mortality rates among adults in the U.S [34]
We examined 5-year and calendar period intervals and annual percent changes (APC) adjusted for each combination of sex, educational level, and race categories to separate the general trend from the effects of age
Summary
Low education is a strong predictor of high mortality in the United States (U.S.). The mortality gap between poorly and highly educated U.S citizens has dramatically increased in recent years, in specific subpopulations [1,2,3]. In the U.S, cancer mortality rates declined by 29%, from 1991 to 2017 [7]. A greater prevalence of cancer and lower screening rates has been reported among Non-Hispanic Blacks (NHB) and individuals with less than high school education, compared to Non-. Cancer mortality in the U.S has fallen in recent decades; individuals with lower levels of education experienced a smaller decline than more highly educated individuals. This analysis aimed to measure the influence of education lower than a high school diploma, on cancer amenable mortality among Non-Hispanic Whites (NHW) and Non-Hispanic Blacks (NHB) in the U.S from 1989 to 2018
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