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Inequalities in life expectancy by educational level and its decomposition in Barcelona, 2004-2018
Xavier Bartoll-Roca1, Maica Rodríguez-Sanz2, Esther Sánchez-Ledesma3
1Agència de Salut Pública de Barcelona, Barcelona (ASPB), Spain; Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain.
Objective:
To analyse the gap in life expectancy by educational level in the city of Barcelona from 2004 to 2018 and to decompose this gap by age and causes of death.
Method:
We computed abridged life tables at the age of 25 years by sex from 2004 to 2018 using standard methods. Educational level was categorised in two groups (lower secondary or less vs. upper secondary or higher education). The life expectancy gap was further decomposed by age and by causes of death based in Arriaga's method in 5-year age blocks up to the age of ≥ 90 years and broad causes of death using ICD-10 codes.
Results:
The life expectancy gap at 25 years by educational level oscillated without trend at around 3.08 years for men and 1.93 years for women. Decomposition by age showed a favourable significant shift in the contribution to this gap from young to older ages for men, with few changes for women. Decomposition by causes of death showed that the diseases concentrating the largest share of the contribution were neoplasms and respiratory and circulatory disease. There was a significant downward trend in external causes for men and in infectious diseases for both men and women but a significant upward trend for respiratory disease for both sexes.
Conclusions:
The stability of the life expectancy gap by educational level during the period analysed resulted from a combination of divergent trends by age and causes of death among high and low educational levels.
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