Does one's own and one's spouse's education affect overall and cause-specific mortality in the elderly?

OBJECTIVES To examine educational gradients in overall and cause-specific mortality among elderly married men and women and their spouses. METHODS Using the census-based Israel Longitudinal Mortality Study (1983-92), 13 573 married men and 6563 married women were identified who were aged 70-89 years at baseline. Cox proportional hazard models were used to assess the strength of the association between education and overall and cause-specific mortality. RESULTS Educational gradients for own and spouse's mortality varied by gender and cause of death. In particular, in relation to cardiovascular disease, men married to uneducated wives experienced elevated mortality risks [hazard ratio (HR) = 1.30; 95% confidence interval (95% CI) 1.11-1.52]. Women were generally unaffected by their husband's education, except for those who died from non-breast cancer, for whom husband's low education had a harmful effect (HR = 1.98; 95% CI 1.26-3.11). CONCLUSIONS Mortality among elderly married persons is associated with one's own and one's spouse's educational achievement. Research using partner's education as a proxy for one's own attainment may be omitting valuable information regarding these and other health risks.