Increasing educational disparities in premature adult mortality, Wisconsin, 1990-2000.

CONTEXT Public health agencies have identified the elimination of health disparities as a major policy objective. OBJECTIVE The primary objective of this study is to assess changes in the association between education and premature adult mortality in Wisconsin, 1990-2000. DESIGN, SETTING, AND SUBJECTS Wisconsin death records (numerators) and US Census data (denominators) were compiled to estimate mortality rates among adults (25-64 years) in 1990 and 2000. Information on the educational status, sex, racial identification, and age of subjects was gathered from these sources. MAIN OUTCOME MEASURE The effect of education on mortality rate ratios in 1990 and 2000 was assessed while adjusting for age, sex, and racial identification. RESULTS Education exhibited a graded effect on mortality rates, which declined most among college graduates from 1990 to 2000. The relative rate of mortality among persons with less than a high school education compared to persons with a college degree increased from 2.4 to 3.1 from 1990-2000-an increase of 29%. Mortality disparities also increased, although to a lesser extent, among other educational groups. CONCLUSION Despite renewed calls for the elimination of health disparities, evidence suggests that educational disparities in mortality increased from 1990 to 2000.