Does shared family background influence the impact of educational differences on early mortality?
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Does shared family background influence the impact of educational differences on early mortality? / Søndergaard, Grethe; Mortensen, Laust H; Andersen, Anne-Marie Nybo; Andersen, Per Kragh; Dalton, Susanne Oksbjerg; Madsen, Mia Lund; Osler, Merete.
In: American Journal of Epidemiology, Vol. 176, No. 8, 2012, p. 675-83.Research output: Contribution to journal › Journal article › peer-review
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TY - JOUR
T1 - Does shared family background influence the impact of educational differences on early mortality?
AU - Søndergaard, Grethe
AU - Mortensen, Laust H
AU - Andersen, Anne-Marie Nybo
AU - Andersen, Per Kragh
AU - Dalton, Susanne Oksbjerg
AU - Madsen, Mia Lund
AU - Osler, Merete
PY - 2012
Y1 - 2012
N2 - The mechanisms behind social differences in mortality rates have been debated. The authors examined the extent to which shared family background and health in early life could explain the association between educational status and all-cause mortality rates using a sibling design. The study was register-based and included all individuals born in Denmark between 1950 and 1979 who had at least 1 full sibling born in the same time period (n = 1,381,436). All individuals were followed from 28 years of age until death, emigration, or December 2009. The authors used Cox regression analyses to estimate hazard ratios for mortality according to educational level. Conventional cohort and intersibling analyses were carried out and conducted separately for deaths occurring before and after the age of 45 years, respectively. The cohort analyses showed an inverse association between educational status and all-cause mortality that was strongest for males, increased with younger birth cohorts, and tended to be strongest in the analyses of death before 45 years of age. The associations were attenuated slightly in the intersibling analyses and after adjustment for serious health conditions in early life. Hence, health selection and confounding by factors shared by siblings explained only a minor part of the association between educational level and all-cause mortality.
AB - The mechanisms behind social differences in mortality rates have been debated. The authors examined the extent to which shared family background and health in early life could explain the association between educational status and all-cause mortality rates using a sibling design. The study was register-based and included all individuals born in Denmark between 1950 and 1979 who had at least 1 full sibling born in the same time period (n = 1,381,436). All individuals were followed from 28 years of age until death, emigration, or December 2009. The authors used Cox regression analyses to estimate hazard ratios for mortality according to educational level. Conventional cohort and intersibling analyses were carried out and conducted separately for deaths occurring before and after the age of 45 years, respectively. The cohort analyses showed an inverse association between educational status and all-cause mortality that was strongest for males, increased with younger birth cohorts, and tended to be strongest in the analyses of death before 45 years of age. The associations were attenuated slightly in the intersibling analyses and after adjustment for serious health conditions in early life. Hence, health selection and confounding by factors shared by siblings explained only a minor part of the association between educational level and all-cause mortality.
KW - Adult
KW - Algorithms
KW - Cause of Death
KW - Denmark
KW - Educational Status
KW - Family
KW - Female
KW - Follow-Up Studies
KW - Health Status Disparities
KW - Humans
KW - Incidence
KW - Male
KW - Middle Aged
KW - Neoplasms
KW - Odds Ratio
KW - Poverty
KW - Proportional Hazards Models
KW - Risk Factors
KW - Siblings
KW - Survival Rate
U2 - 10.1093/aje/kws230
DO - 10.1093/aje/kws230
M3 - Journal article
C2 - 23024135
VL - 176
SP - 675
EP - 683
JO - American Journal of Epidemiology
JF - American Journal of Epidemiology
SN - 0002-9262
IS - 8
ER -
ID: 44353291