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Estonia 1989-2000: enormous increase in mortality differences by education
Mall Leinsalu1, Denny Vågerö, Anton E Kunst
1Stockholm Centre on Health of Societies in Transition, University College of South Stockholm, 14189 Huddinge, Sweden. Mall.Leinsalu@sh.se
International Journal of Epidemiology
|December 19, 2003
Summary
Mortality disparities in Estonia widened significantly between 1989 and 2000. Life expectancy improved for the highly educated, while declining for those with the lowest education levels.
Area of Science:
- Public Health
- Sociology
- Demography
Background:
- Estonia regained political autonomy in 1991, leading to significant societal shifts.
- Analysis of mortality changes by education assesses the impact of these transitions.
Purpose of the Study:
- To analyze mortality trends by educational attainment in Estonia from 1989 to 2000.
- To evaluate the impact of post-autonomy changes and pre-existing factors on mortality differentials.
Main Methods:
- Comparative analysis of census data and national mortality databases (1987-1990 and 1999-2000).
- Examination of cause-specific mortality for individuals aged 20+ across high, mid, and low educational groups.
- Life expectancy and age-standardized mortality rates used for absolute differences; Poisson regression for relative differences (rate ratios).
Main Results:
- Educational disparities in mortality widened substantially between 1989 and 2000.
- Life expectancy increased for higher-educated individuals, while it decreased for the lowest-educated group.
- In 2000, male graduates lived 13.1 years longer than men with the lowest education; for women, the difference was 8.6 years. These trends were consistent across various causes of death and age groups.
Conclusions:
- Widening educational mortality gap is linked to social disruption and increasing wealth inequality.
- Long-term causal processes predating recent reforms also contribute to these growing disparities.