Heterogeneity by age in educational inequalities in cause-specific mortality in women in the Region of Madrid.

BACKGROUND Within Europe, women in the southern regions have the lowest inequalities in mortality. This study evaluates inequalities in mortality from different causes by educational level and their contribution to total mortality inequalities in adult women in one of these regions. METHODS The 2001 population census in the Region of Madrid was linked with deaths in the following 20 months according to the mortality registry. The population of women was stratified into three age groups, and the mortality rate ratio and mortality rate difference by educational level were estimated in each age group. The contribution of each cause of death to total mortality inequality was estimated based on the absolute index of inequality. RESULTS In women aged 45-64 years, no significant relation was observed between educational level and mortality from the leading causes of death. In women aged 25-44 years and in those aged 65 and over, the mortality rate ratios and differences from the leading causes of death gradually increased from the highest to the lowest educational level. AIDS, respiratory diseases and digestive diseases, in young adult women, and cardiovascular diseases, in older women, were the causes of death that contributed most to inequality in mortality. CONCLUSIONS At the beginning of the twenty-first century, mortality inequalities by educational level were not seen in middle-aged adult women in the Region of Madrid. In contrast, mortality inequalities were found in young women and in older women, although the main causes of death that contributed to these inequalities were different in each group.