Educational inequalities in avoidable mortality in Europe

Background The magnitude of educational inequalities in mortality avoidable by medical care in 16 European populations was compared, and the contribution of inequalities in avoidable mortality to educational inequalities in life expectancy in Europe was determined. Methods Mortality data were obtained for people aged 30e64 years. Foreach country, the association between level of education and avoidable mortality was measured with the use of regression-based inequality indexes.Life table analysis was used to calculate the contributionof avoidable causes of death to inequalities in life expectancy between lower and higher educated groups. Results Educational inequalities in avoidable mortality were present in all countries of Europe and in all types of avoidable causes of death. Especially large educational inequalities were found for infectious diseases and conditionsthat require acute care in all countries of Europe. Inequalities were larger in Central Eastern European (CEE) and Baltic countries, followed by Northern and Western European countries, and smallest intheSouthern European regions. This geographic pattern was present in almost all types of avoidable causes of death. Avoidable mortality contributed between 11 and 24% to the inequalities in Partial LifeExpectancy between higher and lower educated groups.Infectious diseases and cardiorespiratory conditions were the main contributors to this difference. Conclusions Inequalities in avoidable mortality werepresent in all European countries, but were especially pronounced inCEE and Baltic countries. Theseeducational inequalities point to an important role for healthcare services in reducing inequalities in health.

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