Educational differentials in US adult mortality: An examination of mediating factors

We use human capital theory to develop hypotheses regarding the extent to which the association between educational attainment and US adult mortality is mediated by such economic and social resources as family income and social support; such health behaviors as inactivity, smoking, and excessive drinking; and such physiological measures as obesity, inflammation, and cardiovascular risk factors. We employ the NHANES Linked Mortality File, a large nationally representative prospective data set that includes an extensive number of factors thought to be important in mediating the education–mortality association. We find that educational differences in mortality for the total population and for specific causes of death are most prominently explained by family income and health behaviors. However, there are age-related differences in the effects of the mediating factors. Higher education enables individuals to effectively coalesce and leverage their diverse and substantial resources to reduce their mortality and increase their longevity.

► We analyze how the education–mortality association is mediated by specific sets of factors.
► We use the NHANES-LMF and multivariate hazards models to test three hypotheses.
► We find that family income and health behaviors are the strongest mediators, but that their effects differ by age.
► Higher levels of education enable individuals to leverage resources to increase their longevity.