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[Differences in mortality by educational level in Italy (2012-2014)].

OBJECTIVES
to evaluate socioeconomic inequalities in mortality by educational level in Italy.


DESIGN
cohort study based on the record linkage between the 2012-2014 archives of mortality and the 2011 Italian population Census.


SETTING AND PARTICIPANTS
Italian population registered in the 2011 Census.


MAIN OUTCOME MEASURES
life expectancy by educational level, age-standardized mortality rates, mortality rate ratios (MRRs) for overall mortality, and 12 groups of causes of death.


RESULTS
life expectancy at birth was 80.3 years among men and 84.9 among women. High-educated men were expected to live 3 years longer than lower educated men, while the gap was narrower in women (1.5 years). Lower educated men had a higher mortality from any cause (MRR: 1.34; 95%CI 1.33-1.35) with larger differentials for lung, upper aerodigestive, and liver cancers, respiratory system diseases, AIDS and accidents. Socioeconomic inequalities were larger in the North-West of the Country for lung and liver cancer. Educational inequalities were smaller among women for all-cause mortality, but remarkably larger for circulatory system diseases (MRR: 1.40; 95%CI 1.38-1.42), particularly in the South (MRR: 1.46; 95%CI 1.42-1.50).


CONCLUSIONS
this study documented socioeconomic inequalities in mortality in Italy for many causes of death; some of them resulted heterogeneous by area of residence. Most of the inequalities can be counteracted with specific measures aimed to improve behavioural risk factors among less educated people.