Educational Level and Stroke Mortality: A Comparison of 10 European Populations during the 1990s

Mauricio Avendaño*, Anton E. Kunst, Martijn Huisman, Frank Van Lenthe, Matthias Bopp, Carme Borrell, Tapani Valkonen, Enrique Regidor, Giuseppe Costa, Angela Donkin, Jens Kristian Borgan, Patrick Deboosere, Sylvie Gadeyne, Teresa Spadea, Otto Andersen, Johan P. Mackenbach

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background and Purpose-Variations between countries in occupational differences in stroke mortality were observed among men during the 1980s. This study estimates the magnitude of differences in stroke mortality by educational level among men and women aged ≥30 years in 10 European populations during the 1990s. Methods-Longitudinal data from mortality registries were obtained for 10 European populations, namely Finland, Norway, Denmark, England/Wales, Belgium, Switzerland, Austria, Turin (Italy), Barcelona (Spain), and Madrid (Spain). Rate ratios (RRs) were calculated to assess the association between educational level and stroke mortality. The life table method was used to estimate the impact of stroke mortality on educational differences in life expectancy. Results-Differences in stroke mortality according to educational level were of a similar magnitude in most populations. However, larger educational differences were observed in Austria. Overall, educational differences in stroke mortality were of similar size among men (RR, 1.27; 95% CI, 1.24 to 1.30) and women (RR, 1.29; 95% CI, 1.27 to 1.32). Educational differences in stroke mortality persisted at all ages in all populations, although they generally decreased with age. Eliminating these differences would on average reduce educational differences in life expectancy by 7% among men and 14% among women. Conclusions-Educational differences in stroke mortality were observed across Europe during the 1990s. Risk factors such as hypertension and smoking may explain part of these differences in several countries. Other factors, such as socioeconomic differences in healthcare utilization and childhood socioeconomic conditions, may have contributed to educational differences in stroke mortality across Europe.

Original languageEnglish
Pages (from-to)432-437
Number of pages6
Issue number2
Publication statusPublished - Feb 2004

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