Kaplan Robert M, Howard Virginia J, Safford Monika M, Howard George
Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, MD.
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL.
Ann Epidemiol. 2015 May;25(5):323-8. doi: 10.1016/j.annepidem.2015.01.017. Epub 2015 Feb 7.
Educational attainment may be an important determinant of life expectancy. However, few studies have prospectively evaluated the relationship between educational attainment and life expectancy using adjustments for other social, behavioral, and biological factors.
The data were from the REasons for Geographic and Racial Differences in Stroke study that enrolled 30,239 black and white adults (≥45 years) between 2003 and 2007. Demographic and cardiovascular risk information was collected and participants were followed for health outcomes. Educational attainment was categorized as less than high school education, high school graduate, some college, or college graduate. Proportional hazards analysis was used to characterize survival by level of education.
Educational attainment and follow-up data were available on 29,657 (98%) of the participants. Over 6.3 years of follow-up, 3673 participants died. There was a monotonically increasing risk of death with lower levels of educational attainment. The same monotonic relationship held with adjustments for age, race, sex, cardiovascular risk factors, and health behaviors. The unadjusted hazard ratio for those without a high school education in comparison with college graduates was 2.89 (95% CI = 2.64-3.18). Although adjustment for income, health behaviors, and cardiovascular risk factors attenuated the relationship, the same consistent pattern was observed after adjustment. The relationship between educational attainment and longevity was similar for black and white participants. The monotonic relationship between educational attainment and longevity was observed for all age groups, except for those aged 85 years or more.
Educational attainment is a significant predictor of longevity. Other factors including age, race, income, health behaviors, and cardiovascular risk factors only partially explain the relationship.
受教育程度可能是预期寿命的一个重要决定因素。然而，很少有研究前瞻性地评估受教育程度与预期寿命之间的关系，并对其他社会、行为和生物学因素进行调整。
数据来自中风地理和种族差异原因研究，该研究在2003年至2007年间招募了30239名黑人和白人成年人（≥45岁）。收集了人口统计学和心血管风险信息，并对参与者的健康结果进行随访。受教育程度分为高中以下、高中毕业生、部分大学学历或大学毕业生。使用比例风险分析来描述按教育水平划分的生存率。
29657名（98%）参与者有受教育程度和随访数据。在超过6.3年的随访中，3673名参与者死亡。随着受教育程度降低，死亡风险呈单调增加。在对年龄、种族、性别、心血管风险因素和健康行为进行调整后，同样的单调关系依然存在。与大学毕业生相比，未接受高中教育者的未调整风险比为2.89（95%CI = （2.64 - 3.18））。尽管对收入、健康行为和心血管风险因素进行调整减弱了这种关系，但调整后仍观察到相同的一致模式。黑人和白人参与者受教育程度与长寿之间的关系相似。除85岁及以上年龄组外，所有年龄组均观察到受教育程度与长寿之间的单调关系。
受教育程度是长寿的重要预测因素。包括年龄、种族、收入、健康行为和心血管风险因素在内的其他因素仅部分解释了这种关系。
