Why Is the Educational Gradient of Mortality Steeper for Men?

Montez, Jennifer Karas; Hayward, Mark D.; Brown, Dustin C.; Hummer, Robert A.
September 2009
Journals of Gerontology Series B: Psychological Sciences & Socia;Sep2009, Vol. 64B Issue 5, p625
Academic Journal
Objectives: It is often documented that the educational gradient of mortality is steeper for men than for women; yet, the explanation remains a matter of debate. We examine gender differences in the gradients within the context of marriage to determine whether overall differences reflect gender differences in health behaviors or a greater influence of men's education on spousal health. Methods. We used data from the 1986 through 1996 National Health Interview Survey Linked Mortality Files for non- Hispanic White adults aged 55 – 84 years at the time of survey. We estimated Cox proportional hazards models to examine the gradients ( N = 180,208). Results. The educational gradient of mortality is marginally steeper for men than for women when aggregating across marital statuses; yet, this reflects a steeper gradient among unmarried men, with low-educated never married men exhibiting high levels of mortality. The gradient among unmarried men is steeper than unmarried women for causes that share smoking as a major risk factor, supporting a behavioral explanation for differences in the gradient. No gender difference in the gradient is observed for married adults. Discussion. Low education and unmarried status exert a synergistic effect on men’s mortality. Unmarried, low-educated men may lack social supports that encourage positive health behaviors.


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