[Differences in mortality by educational level in Italy (2012-2014)]

Area of Science:

• Public Health
• Epidemiology
• Social Determinants of Health

Background:

• Socioeconomic status is a critical determinant of health outcomes.
• Educational level is a key indicator of socioeconomic position and influences health behaviors and access to care.
• Understanding mortality inequalities by education is crucial for public health policy in Italy.

Purpose of the Study:

• To evaluate socioeconomic inequalities in mortality based on educational attainment in the Italian population.
• To identify specific causes of death that exhibit significant disparities across educational levels.
• To explore regional variations in these educational inequalities.

Main Methods:

• A cohort study utilizing record linkage between Italian mortality archives (2012-2014) and the 2011 Italian population Census.
• Inclusion of the entire Italian population registered in the 2011 Census.
• Analysis of life expectancy, age-standardized mortality rates, and mortality rate ratios (MRRs) for overall and cause-specific mortality.

Main Results:

• Higher educational attainment is associated with longer life expectancy; men with higher education live 3 years longer than lower-educated men, while the gap is 1.5 years for women.
• Lower-educated men exhibit higher all-cause mortality (MRR: 1.34), with pronounced differences in lung, upper aerodigestive, and liver cancers, respiratory diseases, AIDS, and accidents.
• Significant regional variations exist; inequalities for lung and liver cancer are larger in North-West Italy, while circulatory disease inequalities are greater in Southern Italy, especially for women (MRR: 1.46).

Conclusions:

• The study confirms substantial socioeconomic inequalities in mortality across various causes in Italy, with regional heterogeneity.
• Educational disparities in mortality are evident for numerous causes of death, including specific cancers and diseases.
• Interventions targeting behavioral risk factors among less educated individuals are essential to mitigate these observed health inequalities.