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Education, cognitive ability, and cause-specific mortality: A structural approach.
Govert E Bijwaard1, Per Tynelius2,3, Mikko Myrskylä4,5,6
1a Netherlands Interdisciplinary Demographic Institute.
Population Studies
|August 11, 2018
Summary
Higher education levels are linked to fewer deaths, but this relationship may be overestimated. Structural models reveal smaller effects, especially for external causes among less educated individuals.
Area of Science:
- Social Epidemiology
- Public Health
- Biostatistics
Background:
- Education is inversely associated with mortality from major causes of death.
- Previous research often overlooks the interdependence of cause-specific mortality hazards.
- Both education and mortality are influenced by underlying cognitive ability.
Purpose of the Study:
- To analyze the relationship between education and cause-specific mortality, accounting for interdependence and cognitive ability.
- To address potential biases in conventional analyses of education and mortality.
Main Methods:
- Analysis of Swedish men aged 18-63.
- Focus on 'months lost' to specific causes to address hazard interdependence.
- Application of a structural model to control for confounding by cognitive ability (Intelligence Quotient).
Main Results:
- Standard Cox models controlling for Intelligence Quotient show large decreases in mortality with improved education.
- Structural models indicate smaller decreases in months lost for most causes and education levels.
- Significant reductions in months lost, particularly from external causes (accidents, suicide), are observed among the least educated with improved education.
Conclusions:
- Conventional analyses of education and mortality may be biased, even after controlling for observed cognitive ability.
- The benefits of education on mortality are more nuanced than previously suggested, especially concerning external causes for lower education groups.
- Structural modeling provides a more accurate assessment of the education-mortality gradient.
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