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Is an educated wife hazardous to your health?
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Men with more educated wives face higher risks of fatal ischemic heart disease. This increased risk, particularly for less educated men, suggests a link between educational status incongruity and heart health.
Area of Science:
- Sociomedical Science
- Cardiovascular Epidemiology
- Health Disparities Research
Background:
- Previous studies show mixed results on the association between educational discordance and coronary heart disease risk.
- One study found no link for coronary heart disease exclusive of angina, while others suggest increased risk.
Purpose of the Study:
- To investigate if educational discordance predicts ischemic heart disease (IHD) death.
- To examine the relationship between men's and wives' educational levels and male mortality from IHD.
Main Methods:
- Prospective cohort study of 1698 spouse pairs aged 45-79 years.
- Nine-year follow-up period to ascertain all-cause and IHD mortality.
- Analysis of educational discordance (wife more educated than husband) as a predictor of mortality.
Main Results:
- Men with more educated wives had a significantly increased risk of all-cause and IHD death compared to men with less educated wives.
- The highest risk was observed in the least educated men with the most educated wives.
- The association persisted after adjusting for age, socioeconomic status, blood pressure, and other risk factors.
Conclusions:
- Educational status incongruity is a significant risk factor for fatal ischemic heart disease.
- These findings support a causal role for status incongruity in cardiovascular mortality.
- Interventions addressing social status and its health impacts may be warranted.
Abstract:
Three of four previous studies have suggested that men whose wives are more educated than they are at increased risk of coronary heart disease, defined to include angina pectoris, but one study of coronary heart disease exclusive of angina failed to show an association with educational discordance. In this study, the authors used data from a cohort of 1698 spouse pairs aged 45-79 years who were followed prospectively for nine years to determine whether discordance for education was predictive of ischemic heart disease death. In this upper-middle-class population, men with more educated wives tended to be older, had a lower socioeconomic status, and higher blood pressure levels. A significant increase in risk of all-cause and ischemic heart disease death was seen in men whose wives were more educated than they, compared with men whose wives were less educated. This risk was highest for the least educated men with the most educated wives, and was not totally explained by differences in age, socioeconomic status, blood pressure, or other risk factors. These data support a causal role for status incongruity and fatal ischemic heart disease.