Shared Family Factors and Educational Inequalities in Mortality: Results from 1.7 Million Swedish Siblings

Laust Mortensen, University of Copenhagen
Jenny Torssander, Swedish Institute for Social Research

To separate the association between education and mortality from family factors affecting them both, we compared Swedish siblings with different levels of education. The analyses were based on 1,732,119 individuals born between 1934 and 1959 and present in Swedish population registers and followed their death records until the end of 2012 (167,932 deaths). We observed a strong family aggregation of education. The relative educational gradient in all-cause mortality was lower within sibships than in the population as a whole. The cause-specific analyses revealed that there is a clear reduction in educational inequalities in lung cancer and diabetes when introducing shared family factors. In contrast, educational inequalities in suicide and other mental disorders increased when family factors were controlled for. Our findings are consistent with the explanation that family factors explain part of the association between education and mortality. Robustness and bias is discussed is the paper.