Causal effect of education on mortality in a quasi-experiment on 1.2 million Swedes

Anton Carl Jonas Lager; Jenny Torssander

doi:10.1073/pnas.1105839109

New Research In

Edited by Kenneth Wachter, University of California, Berkeley, CA, and approved April 4, 2012 (received for review April 19, 2011)

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Fig. 1.
Analytic sample of study.

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Table 1.

Mortality rates between ages 15 and 64 (deaths per 100,000 person years) by age, sex, and birth cohort

Age and cohort	Men						Women
Age	15–19	20–29	30–39	40–49	50–59	60–64	15–19	20–29	30–39	40–49	50–59	60–64
Birth cohort
1943	N/A	106	147	266	561	979	N/A	51	84	165	371	631
1944	N/A	109	139	250	523	N/A	N/A	47	81	161	358	N/A
1945	98	102	142	249	499	N/A	38	50	76	169	343	N/A
1946	87	104	141	253	496	N/A	43	49	69	154	332	N/A
1947	90	104	138	246	501	N/A	40	45	71	149	321	N/A
1948	88	108	139	225	461	N/A	39	46	67	152	314	N/A
1949	88	113	133	214	N/A	N/A	43	44	68	146	N/A	N/A
1950	87	110	120	223	N/A	N/A	38	49	71	138	N/A	N/A
1951	80	111	125	221	N/A	N/A	36	47	77	144	N/A	N/A
1952	82	111	124	223	N/A	N/A	36	40	64	135	N/A	N/A
1953	97	105	124	211	N/A	N/A	42	41	72	144	N/A	N/A
1954	91	109	129	213	N/A	N/A	38	45	58	131	N/A	N/A
1955	91	114	132	201	N/A	N/A	37	46	60	129	N/A	N/A
All	89	108	134	231	507	979	39	46	71	148	340	631

N/A, not applicable.

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Table 2.

Effect of the reform on all-cause mortality among men and women before age 40, in age 40 and after, and during the full follow-up, hazard ratios (95% CI)

Follow-up period (no. of deaths: men/women)	Men (n before 40 and all ages = 639,473; n after age 40 = 613,842)	Women (n before 40 and all ages = 608,394; n after age 40 = 586,677)	All (n before 40 and all ages = 1,247,867; n after age 40 = 1,200,519)
Before age 40 (18,496/8,526)	1.03 (0.97–1.08)	1.02 (0.95–1.10)	1.03 (0.98–1.07)
Age 40 and after (39,867/25,462)	0.96 (0.92–1.00)	0.95 (0.91–1.00)	0.96 (0.93–0.99)
All ages (58,363/33,988)	[0.98 (0.95–1.02)]^*	0.97 (0.94–1.01)	0.98 (0.95–1.01)

Boldface represents significant P value (P < 0.05). All models include control for birth cohort and municipality fixed-effects. SEs are clustered at the municipal level. The pooled models (both women and men) include control for sex.
↵*Violation of the proportional hazard assumption.

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Table 3.

Effect of the reform on cause-specific mortality after age 40, hazard ratios (95% CI)

Cause of death (no. of deaths: men/women)	Men (n = 613,842)	Women (n = 586,677)	All (n = 1,200,519)
Cancer (11,553/13,827)	0.94 (0.87–1.01)	0.94 (0.88–1.01)	0.94(0.90–0.99)
Of lung/trachea/bronchus/larynx (2,221/2,471)	0.93 (0.78–1.10)	0.83(0.71–0.98)	0.88(0.78–0.99)
Of breast (17/3,480)	0.75 (0.04–15.10)	1.01 (0.89–1.15)	1.01 (0.89–1.15)
Of lymphatic/hematopoietic tissue (1,211/762)	0.89 (0.70–1.12)	0.75 (0.55–1.02)	0.83 (0.69–1.01)
All other cancers (8,104/7,114)	0.95 (0.86–1.04)	0.97 (0.89–1.06)	0.96 (0.90–1.02)
Circulatory diseases (11,474/3,951)	1.04 (0.96–1.13)	0.95 (0.84–1.07)	1.01 (0.95–1.09)
Ischemic heart diseases (7,016/1,612)	1.07 (0.97–1.19)	0.80(0.66–0.97)	1.02 (0.92–1.12)
Cerebrovascular diseases (1,767/1,220)	1.03 (0.86–1.22)	1.04 (0.84–1.28)	1.03 (0.90–1.17)
All other circulatory diseases (2,691/1,119)	0.96 (0.84–1.11)	1.08 (0.86–1.36)	1.00 (0.88–1.13)
External causes (7,676/2,845)	0.90(0.83–0.98)	0.97 (0.83–1.12)	[0.92(0.85–0.99)]^†
Accidents (3,190/962)	0.85(0.75–0.97)	0.91 (0.72–1.15)	0.87(0.77–0.98)
Suicide and intentional self harm (3,180/1,288)	0.89 (0.78–1.01)	0.98 (0.78–1.22)	[0.91 (0.82–1.02)]^†
All other external causes (1,306/595)	1.06 (0.86–1.30)	1.06 (0.79–1.42)	1.06 (0.89–1.25)
All other causes (9,164/4,839)	0.95 (0.88–1.03)	0.99 (0.88–1.10)	0.96 (0.90–1.03)

Boldface represents significant P value (P < 0.05). All models include control for birth cohort and municipality fixed-effects. SEs are clustered at the municipal level. The pooled models (both women and men) include control for sex.
↵^†Significant interaction sex*reform.

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Table 4.

Effect of the reform on all-cause mortality for individuals with different levels of highest attained educational level at the end of 1985, hazard ratios (95% CI)

	All	Compulsory	Vocational	Senior secondary	Tertiary less than 3 y	Tertiary 3 y or more
Men	0.96 (0.92–1.00)	0.95 (0.89–1.01)	0.93(0.87–0.99)	0.96 (0.86–1.08)	1.07 (0.91–1.26)	1.06 (0.94–1.20)
Dead/n	40,260/596,769	14,856/173,896	12,071/162,702	5,062/89,627	2,275/53,537	3,140/83,695
Women	0.96 (0.92–1.00)	0.92 (0.84–1.01)	0.92(0.85–0.99)	1.16 (0.97–1.39)	1.01 (0.86–1.19)	0.93 (0.78–1.09)
Dead/n	25,647/574,629	7,961/133,735	9,231/205,271	1,631/47,501	2,246/74,468	2,339/73,356
All	0.96(0.93–0.99)	0.94(0.89–0.99)	0.92(0.88–0.97)	1.01 (0.92–1.12)	1.03 (0.92–1.15)	1.00 (0.90–1.12)
Dead/n	65,907/1,171,398	22,817/307,631	21,302/367,973	6,693/137,128	4,521/128,005	5,479/157,051

Boldface represents significant P value (P < 0.05). The pooled models (both women and men) include control for sex. Follow-up between January 1986 and December 2007.