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Enabling the examination of long-term mortality trends by educational level for England and Wales in a time-consistent and internationally comparable manner

Janssen, Fanny; Van Hemelrijck, Wanda; Kagenaar, Eva; Sizer, Alison; (2024) Enabling the examination of long-term mortality trends by educational level for England and Wales in a time-consistent and internationally comparable manner. Population Health Metrics , 22 , Article 4. 10.1186/s12963-024-00324-2. Green open access

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Abstract

Background: Studying long-term trends in educational inequalities in health is important for monitoring and policy evaluation. Data issues regarding the allocation of people to educational groups hamper the study and international comparison of educational inequalities in mortality. For the UK, this has been acknowledged, but no satisfactory solution has been proposed. // Objective: To enable the examination of long-term mortality trends by educational level for England and Wales (E&W) in a time-consistent and internationally comparable manner, we propose and implement an approach to deal with the data issues regarding mortality data by educational level. // Methods: We employed 10-year follow-ups of individuals aged 20+ from the Office for National Statistics Longitudinal Study (ONS-LS), which include education information from each decennial census (1971–2011) linked to individual death records, for a 1% representative sample of the E&W population. We assigned the individual cohort data to single ages and calendar years, and subsequently obtained aggregate all-cause mortality data by education, sex, age (30+), and year (1972–2017). Our data adjustment approach optimised the available education information at the individual level, and adjusts—at the aggregate level—for trend discontinuities related to the identified data issues, and for differences with country-level mortality data for the total population. // Results: The approach resulted in (1) a time-consistent and internationally comparable categorisation of educational attainment into the low, middle, and high educated; (2) the adjustment of identified data-quality related discontinuities in the trends over time in the share of personyears and deaths by educational level, and in the crude and the age-standardised death rate by and across educational levels; (3) complete mortality data by education for ONS-LS members aged 30+ in 1972–2017 which aligns with country-level mortality data for the total population; and (4) the estimation of inequality measures using established methods. For those aged 30+ , both absolute and relative educational inequalities in mortality first increased and subsequently decreased. // Conclusion: We obtained additional insights into long-term trends in educational inequalities in mortality in E&W, and illustrated the potential effects of different data issues. We recommend the use of (part of) the proposed approach in other contexts.

Type: Article
Title: Enabling the examination of long-term mortality trends by educational level for England and Wales in a time-consistent and internationally comparable manner
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1186/s12963-024-00324-2
Publisher version: https://doi.org/10.1186/s12963-024-00324-2
Language: English
Additional information: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Keywords: Educational attainment, Educational classifcation, Mortality, Socioeconomic inequalities, Trends, Data issues
UCL classification: UCL
UCL > Provost and Vice Provost Offices > UCL SLASH
UCL > Provost and Vice Provost Offices > UCL SLASH > Faculty of Arts and Humanities
UCL > Provost and Vice Provost Offices > UCL SLASH > Faculty of Arts and Humanities > Dept of Information Studies
URI: https://discovery.ucl.ac.uk/id/eprint/10202943
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