Education and pneumonia mortality: a trend analysis of its inequalities in Colombian adults
Objective To explore the existence and trends of social inequalities related to pneumonia mortality in Colombian adults using educational level as a proxy of socioeconomic status. Methods We obtained individual and anonymised registries from death certificates due to pneumonia for 1998–2015. Educati...
- Autores:
-
ALVIS-ZAKZUK, NELSON J.
Arroyave, Ivan
Castañeda-Orjuela, Carlos
DE LA HOZ RESTREPO, FERNANDO
Alvis-Guzmán, Nelson
- Tipo de recurso:
- Article of journal
- Fecha de publicación:
- 2020
- Institución:
- Corporación Universidad de la Costa
- Repositorio:
- REDICUC - Repositorio CUC
- Idioma:
- eng
- OAI Identifier:
- oai:repositorio.cuc.edu.co:11323/7647
- Acceso en línea:
- https://hdl.handle.net/11323/7647
http://dx.doi.org/10.1136/bmjresp-2020-000695
https://repositorio.cuc.edu.co/
- Palabra clave:
- Education
Pneumonia
Mortality
Colombian adults
- Rights
- openAccess
- License
- CC0 1.0 Universal
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Education and pneumonia mortality: a trend analysis of its inequalities in Colombian adults |
| title |
Education and pneumonia mortality: a trend analysis of its inequalities in Colombian adults |
| spellingShingle |
Education and pneumonia mortality: a trend analysis of its inequalities in Colombian adults Education Pneumonia Mortality Colombian adults |
| title_short |
Education and pneumonia mortality: a trend analysis of its inequalities in Colombian adults |
| title_full |
Education and pneumonia mortality: a trend analysis of its inequalities in Colombian adults |
| title_fullStr |
Education and pneumonia mortality: a trend analysis of its inequalities in Colombian adults |
| title_full_unstemmed |
Education and pneumonia mortality: a trend analysis of its inequalities in Colombian adults |
| title_sort |
Education and pneumonia mortality: a trend analysis of its inequalities in Colombian adults |
| dc.creator.fl_str_mv |
ALVIS-ZAKZUK, NELSON J. Arroyave, Ivan Castañeda-Orjuela, Carlos DE LA HOZ RESTREPO, FERNANDO Alvis-Guzmán, Nelson |
| dc.contributor.author.spa.fl_str_mv |
ALVIS-ZAKZUK, NELSON J. Arroyave, Ivan Castañeda-Orjuela, Carlos DE LA HOZ RESTREPO, FERNANDO Alvis-Guzmán, Nelson |
| dc.subject.spa.fl_str_mv |
Education Pneumonia Mortality Colombian adults |
| topic |
Education Pneumonia Mortality Colombian adults |
| description |
Objective To explore the existence and trends of social inequalities related to pneumonia mortality in Colombian adults using educational level as a proxy of socioeconomic status. Methods We obtained individual and anonymised registries from death certificates due to pneumonia for 1998–2015. Educational level data were gathered from microdata of the Colombian Demography Health Surveys. Rate ratios (RR) were estimated by using Poisson regression models, comparing mortality of educational groups with mortality in the highest education group. Relative index of inequality (RII) was measured to assess changes in disparities, regressing mortality on the midpoint of the cumulative distribution of education, thereby considering the size of each educational group. Results For adults 25+ years, the risk of dying was significantly higher among lower educated. The RRs depict increased risks of dying comparing lower and highest education level, and this tendency was stronger in woman than in men (RR for primary education=2.34 (95% CI 2.32 to 2.36), RR for secondary education=1.77 (95% CI 1.75 to 1.78) versus RR for primary education=1.83 (95% CI 1.81 to 1.85), RR for secondary education=1.51 (95% CI 1.50 to 1.53)). According to age groups, young adults (25–44 years) showed the largest inequality in terms of educational level; RRs for pneumonia mortality regarding the tertiary educated groups show increased mortality in the lower and secondary educated, and these differences decreased with ages. RII in pneumonia mortality among adult men was 2.01 (95% CI 2.00 to 2.03) and in women 2.46 (95% CI 2.43 to 2.48). The RII was greatest at young ages, for both sexes. Time trends showed steadily significant increases for RII in both men and women (estimated annual percentage change (EAPC)men=3.8; EAPCwomen=2.6). Conclusion A significant increase on the educational inequalities in mortality due to pneumonia during all period was found among men and women. Efforts to reduce pneumonia mortality in adults improving population health by raising education levels should be strengthened with policies that assure widespread access to economic and social opportunities |
| publishDate |
2020 |
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2020-12-29T20:06:02Z |
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2020-12-29T20:06:02Z |
| dc.date.issued.none.fl_str_mv |
2020-10-03 |
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Artículo de revista |
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http://purl.org/coar/resource_type/c_2df8fbb1 |
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http://purl.org/coar/resource_type/c_6501 |
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Text |
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info:eu-repo/semantics/article |
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http://purl.org/redcol/resource_type/ART |
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info:eu-repo/semantics/acceptedVersion |
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acceptedVersion |
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https://hdl.handle.net/11323/7647 |
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http://dx.doi.org/10.1136/bmjresp-2020-000695 |
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Corporación Universidad de la Costa |
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REDICUC - Repositorio CUC |
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https://repositorio.cuc.edu.co/ |
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https://hdl.handle.net/11323/7647 http://dx.doi.org/10.1136/bmjresp-2020-000695 https://repositorio.cuc.edu.co/ |
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Corporación Universidad de la Costa REDICUC - Repositorio CUC |
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eng |
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eng |
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1 Barnes SR, Wansaula Z, Herrick K, et al. Mortality estimates among adult patients with severe acute respiratory infections from two sentinel hospitals in southern Arizona, United States, 2010–2014. BMC Infect Dis 2018;18:4–11. 2 World Health Organization. The top 10 causes of death. WHO 2017. 3 World Health Organization. Who fact sheet: the top 10 causes of death. 4 Mathers C, Stevens G, Hogan D, et al. Global and regional causes of death: patterns and trends, 2000–15. In: Disease Control Priorities: Improving Health and Reducing Poverty. 3rd edn. The International Bank for Reconstruction and Development/The World Bank, 2017. 5 Htun TP, Sun Y, Chua HL, et al. Clinical features for diagnosis of pneumonia among adults in primary care setting: a systematic and meta-review. Sci Rep 2019;9:7600. 6 Cillóniz C, Cardozo C, García-Vidal C. Epidemiology, pathophysiology, and microbiology of community-acquired pneumonia. Ann Res Hosp 2018;2:1. 7 Castañeda-Orjuela C, Alvis-Guzmán N, de la Hoz-Restrepo F. [The impact of pneumococcal disease on adults living in Bogota, Colombia, 2008]. Rev Salud Publica 2010;12:38–50. 8 Castañeda-Orjuela C, Alvis-Guzmán N, Paternina AJ, et al. Cost-Effectiveness of the introduction of the pneumococcal polysaccharide vaccine in elderly Colombian population. Vaccine 2011;29:7644–50. 9 Li X, Blais JE, Wong ICK, et al. Population-Based estimates of the burden of pneumonia hospitalizations in Hong Kong, 2011-2015. Eur J Clin Microbiol Infect Dis 2019;38:553–61. 10 Jackson LA, Neuzil KM, Yu O, et al. Effectiveness of pneumococcal polysaccharide vaccine in older adults. N Engl J Med 2003;348:1747–55. 11 Watson L, Wilson BJ, Waugh N. Pneumococcal polysaccharide vaccine: a systematic review of clinical effectiveness in adults. Vaccine 2002;20:2166–73. 12 Moore RA, Wiffen PJ, Lipsky BA. Are the pneumococcal polysaccharide vaccines effective? meta-analysis of the prospective trials. BMC Fam Pract 2000;1:1. 13 Conaty S, Watson L, Dinnes J, et al. The effectiveness of pneumococcal polysaccharide vaccines in adults: a systematic review of observational studies and comparison with results from randomised controlled trials. Vaccine 2004;22:3214–24. 14 Webb BJ, Sorensen J, Mecham I, et al. Antibiotic use and outcomes after implementation of the drug resistance in pneumonia score in ED patients with community-onset pneumonia. Chest 2019;156:843–51. 15 McCabe C, Kirchner C, Zhang H, et al. Guideline-concordant therapy and reduced mortality and length of stay in adults with community-acquired pneumonia: playing by the rules. Arch Intern Med 2009;169:1525. 16 Rudan I, El Arifeen S, Bhutta ZA, et al. Setting research priorities to reduce global mortality from childhood pneumonia by 2015. PLoS Med 2011;8:e1001099. 17 Buzzo AR, Roberts C, Mollinedo LG, et al. Morbidity and mortality of pneumonia in adults in six Latin American countries. Int J Infect Dis 2013;17:e673–7. 18 Lewer D, Jayatunga W, Aldridge RW, et al. Premature mortality attributable to socioeconomic inequality in England between 2003 and 2018: an observational study. Lancet Public Health 2020;5:e33–41. 19 Kaplan V, Angus DC, Griffin MF, et al. Hospitalized communityacquired pneumonia in the elderly: age- and sex-related patterns of care and outcome in the United States. Am J Respir Crit Care Med 2002;165:766–72. 20 Vrbova L, Mamdani M, Moineddin R, et al. Does socioeconomic status affect mortality subsequent to hospital admission for community acquired pneumonia among older persons? J Negat Results Biomed 2005;4:1–8. 21 Ahmad OB, Boschi-Pinto C, Lopez AD, et al. Age standardization of rates: a new who standard. GPE Discuss Pap Ser 2001:1–14. 22 Kitagawa EM, Hauser PM. Differential mortality in the United States: a study in socioeconomic epidemiology. Cambridge, MA: Harvard Univ Press, 1973. 23 Antonovsky A. Social class, life expectancy and overall mortality. Milbank Mem Fund Q 1967;45:31–73. 24 Adler NE, Rehkopf DH. U.S. disparities in health: descriptions, causes, and mechanisms. Annu Rev Public Health 2008;29:235–52. 25 Link BG, Phelan J. Social conditions as fundamental causes of disease. J Health Soc Behav 1995;Spec No:80–94. 26 Phelan JC, Link BG, Diez-Roux A, et al. "Fundamental causes" of social inequalities in mortality: a test of the theory. J Health Soc Behav 2004;45:265–85. 27 Everett BG, Rehkopf DH, Rogers RG. The nonlinear relationship between education and mortality: an examination of cohort, Race/Ethnic, and gender differences. Popul Res Policy Rev 2013;32:893–917. 28 Oakes JM, Rossi PH. The measurement of Ses in health research: current practice and steps toward a new approach. Soc Sci Med 2003;56:769–84. 29 Hummer RA, Lariscy JT. Educational attainment and adult mortality. In: International Handbook of adult mortality. Springer, 2011: 241–61. 30 Braveman PA, Cubbin C, Egerter S, et al. Socioeconomic disparities in health in the United States: what the patterns tell us. Am J Public Health 2010;100:S186–96. 31 Montez JK, Berkman LF. Trends in the educational gradient of mortality among US adults aged 45 to 84 years: bringing regional context into the explanation. Am J Public Health 2014;104:e82–90. 32 Mackenbach JP, Kunst AE, Groenhof F, et al. Socioeconomic inequalities in mortality among women and among men: an international study. Am J Public Health 1999;89:1800–6. 33 Mason A. NIH public access. 2009;19:389–99. 34 Economic Commission for Latin America and the Caribbean. Statistical Yearbook for Latin America and the Caribbean | economic Commission for Latin America and the Caribbean. 35 Chaves MdelP, Fernández JA, Ospina I, et al. [Giardia duodenalis prevalence and associated risk factors in preschool and school-age children of rural Colombia]. Biomedica 2007;27:345–51. 36 Castillo-Riquelme M, Guhl F, Turriago B, et al. The costs of preventing and treating Chagas disease in Colombia. PLoS Negl Trop Dis 2008;2:e336. 37 Uscátegui RM, Correa AM. [Nutritional status of children with malaria in northwest Colombia]. Biomedica 2007;27:559–70. 38 Pardo RH, Carvajal A, Ferro C, et al. Effect of knowledge and economic status on sandfly control activities by householders at risk of cutaneous leishmaniasis in the subandean region of Huila department, Colombia. Biomedica 2006;26:167–79. 39 Quintero J, Carrasquilla G, Suárez R, et al. An ecosystemic approach to evaluating ecological, socioeconomic and group dynamics affecting the prevalence of Aedes aegypti in two Colombian towns. Cad Saude Publica 2009;25:s93–103. 40 de Vries E, Arroyave I, Pardo C. Re-Emergence of educational inequalities in cervical cancer mortality, Colombia 1998–2015. J Cancer Policy 2018;15:37–44. 41 de Vries E, Arroyave I, Pardo C. Time trends in educational inequalities in cancer mortality in Colombia, 1998-2012. BMJ Open 2016;6:e008985. 42 Raghunathan T, Lepkowski J, Van Hoewyk J, et al. A multivariate technique for multiply imputing missing values using a sequence of regression models. Surv Methodol 2001;27:85–95. 43 Kunst AE, Groenhof F, Borgan JK, et al. Socio-Economic inequalities in mortality. methodological problems illustrated with three examples from Europe. Rev Epidemiol Sante Publique 1998;46:467–79. 44 Ojeda G, Ordóñez GM, Ochoa LH. Colombia: Encuesta nacional de demografía Y salud, 2010. Bogotá]: Calverton (Md), US: Asociación Probienestar de la Familia Colombiana, Profamilia; ORC Macro International, 2011. 45 Departamento Administrativo Nacional de Estadística (DANE). Tablas de mortalidad nacionales Y departamentales 1985-2020. Bogotá D.C: Departamento Administrativo Nacional de Estadística (DANE), Colombia, 2007. 46 United States Census Bureau, Population Analysis System (PASEX), Population Analysis Spreadsheets, International Programs Center (IPC). United States census bureau. Washington DC, 2011. 47 I. SAS Institute, The MIANALYZE Procedure, in: S.I. Inc. User’s Guide SAS/STAT® 9.2. Cary, NC: SAS Institute Inc, 2008: 201–33. 48 National Cancer Institute - Statistical Research and Applications Branch. No title. Joinpoint Regres Progr 2013. 49 Gillis D, Edwards BPM. The utility of joinpoint regression for estimating population parameters given changes in population structure. Heliyon 2019;5:e02515. 50 Kim HJ, Fay MP, Feuer EJ, et al. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med 2000;19:335–51. 51 Mackenbach JP, Kunst AE. Measuring the magnitude of socioeconomic inequalities in health: an overview of available measures illustrated with two examples from Europe. Soc Sci Med 1997;44:757–71. 52 Mackenbach JP, Kunst AE. Measuring the magnitude of socioeconomic inequalities in health: an overview of available measures illustrated with two examples from Europe. Soc Sci Med 1997;44:757–71. 53 Harper S, Lynch J, Meersman SC, et al. An overview of methods for monitoring social disparities in cancer with an example using trends in lung cancer incidence by area-socioeconomic position and raceethnicity, 1992-2004. Am J Epidemiol 2008;167:889–99. 54 GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the global burden of disease study 2017. Lancet 2018;392:1736–88. 55 Huisman M, Kunst AE, Bopp M, et al. Educational inequalities in cause-specific mortality in middle-aged and older men and women in eight Western European populations. Lancet 2005;365:493–500. 56 Rogers AC. Vulnerability, health and health care. J Adv Nurs 1997;26:65–72. 57 Grosse RN, Auffrey C. Literacy and health status in developing countries. Annu Rev Public Health 1989;10:281–97. 58 Mackenbach JP, Huisman M, Andersen O, et al. Inequalities in lung cancer mortality by the educational level in 10 European populations. Eur J Cancer 2004;40:126–35. 59 Manor O, Eisenbach Z, Friedlander Y, et al. Educational differentials in mortality from cardiovascular disease among men and women: the Israel longitudinal mortality study. Ann Epidemiol 2004;14:453–60. 60 Stirbu I, Kunst AE, Bopp M, et al. Educational inequalities in avoidable mortality in Europe. J Epidemiol Community Health 2010;64:913–20. 61 Nuorti PJ, Butler JC. Prevention of pneumococcal disease: recommendations of the Advisory Committee on immunization. MMWR Morb Mortal Wkly Rep 1997;46:1–24. 62 Cano GC, Reyes-Ortiz C, Borda MG, et al. Self-Reported vaccination in the elderly: SABE Bogota study, Colombia. Colomb Med 2016;47:25–30. 63 Narváez J, Osorio MB, Castañeda-Orjuela C, et al. Is Colombia reaching the goals on infant immunization coverage? A quantitative survey from 80 municipalities. Vaccine 2017;35:1501–8. 64 Barro RJ, Lee J. A new data set of educational attainment in the world, 1950–2010 (NBER working paper series No. 15902) 2010. 65 Montez JK, Barnes K. The benefits of educational attainment for U.S. adult mortality: are they contingent on the broader environment? Popul Res Policy Rev 2016. |
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ALVIS-ZAKZUK, NELSON J.Arroyave, IvanCastañeda-Orjuela, CarlosDE LA HOZ RESTREPO, FERNANDOAlvis-Guzmán, Nelson2020-12-29T20:06:02Z2020-12-29T20:06:02Z2020-10-03https://hdl.handle.net/11323/7647http://dx.doi.org/10.1136/bmjresp-2020-000695Corporación Universidad de la CostaREDICUC - Repositorio CUChttps://repositorio.cuc.edu.co/Objective To explore the existence and trends of social inequalities related to pneumonia mortality in Colombian adults using educational level as a proxy of socioeconomic status. Methods We obtained individual and anonymised registries from death certificates due to pneumonia for 1998–2015. Educational level data were gathered from microdata of the Colombian Demography Health Surveys. Rate ratios (RR) were estimated by using Poisson regression models, comparing mortality of educational groups with mortality in the highest education group. Relative index of inequality (RII) was measured to assess changes in disparities, regressing mortality on the midpoint of the cumulative distribution of education, thereby considering the size of each educational group. Results For adults 25+ years, the risk of dying was significantly higher among lower educated. The RRs depict increased risks of dying comparing lower and highest education level, and this tendency was stronger in woman than in men (RR for primary education=2.34 (95% CI 2.32 to 2.36), RR for secondary education=1.77 (95% CI 1.75 to 1.78) versus RR for primary education=1.83 (95% CI 1.81 to 1.85), RR for secondary education=1.51 (95% CI 1.50 to 1.53)). According to age groups, young adults (25–44 years) showed the largest inequality in terms of educational level; RRs for pneumonia mortality regarding the tertiary educated groups show increased mortality in the lower and secondary educated, and these differences decreased with ages. RII in pneumonia mortality among adult men was 2.01 (95% CI 2.00 to 2.03) and in women 2.46 (95% CI 2.43 to 2.48). The RII was greatest at young ages, for both sexes. Time trends showed steadily significant increases for RII in both men and women (estimated annual percentage change (EAPC)men=3.8; EAPCwomen=2.6). Conclusion A significant increase on the educational inequalities in mortality due to pneumonia during all period was found among men and women. Efforts to reduce pneumonia mortality in adults improving population health by raising education levels should be strengthened with policies that assure widespread access to economic and social opportunitiesALVIS-ZAKZUK, NELSON J.-will be generated-orcid-0000-0001-9382-214X-600Arroyave, IvanCastañeda-Orjuela, Carlos-will be generated-orcid-0000-0002-8735-6223-600DE LA HOZ RESTREPO, FERNANDO-will be generated-orcid-0000-0001-9436-7935-600Alvis-Guzmán, Nelson-will be generated-orcid-0000-0001-9458-864X-600application/pdfengCorporación Universidad de la CostaCC0 1.0 Universalhttp://creativecommons.org/publicdomain/zero/1.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Respiratory Epidemiologyhttps://bmjopenrespres.bmj.com/content/7/1/e000695EducationPneumoniaMortalityColombian adultsEducation and pneumonia mortality: a trend analysis of its inequalities in Colombian adultsArtículo de revistahttp://purl.org/coar/resource_type/c_6501http://purl.org/coar/resource_type/c_2df8fbb1Textinfo:eu-repo/semantics/articlehttp://purl.org/redcol/resource_type/ARTinfo:eu-repo/semantics/acceptedVersion1 Barnes SR, Wansaula Z, Herrick K, et al. Mortality estimates among adult patients with severe acute respiratory infections from two sentinel hospitals in southern Arizona, United States, 2010–2014. BMC Infect Dis 2018;18:4–11.2 World Health Organization. The top 10 causes of death. WHO 2017.3 World Health Organization. Who fact sheet: the top 10 causes of death.4 Mathers C, Stevens G, Hogan D, et al. Global and regional causes of death: patterns and trends, 2000–15. In: Disease Control Priorities: Improving Health and Reducing Poverty. 3rd edn. The International Bank for Reconstruction and Development/The World Bank, 2017.5 Htun TP, Sun Y, Chua HL, et al. Clinical features for diagnosis of pneumonia among adults in primary care setting: a systematic and meta-review. Sci Rep 2019;9:7600.6 Cillóniz C, Cardozo C, García-Vidal C. Epidemiology, pathophysiology, and microbiology of community-acquired pneumonia. Ann Res Hosp 2018;2:1.7 Castañeda-Orjuela C, Alvis-Guzmán N, de la Hoz-Restrepo F. [The impact of pneumococcal disease on adults living in Bogota, Colombia, 2008]. Rev Salud Publica 2010;12:38–50.8 Castañeda-Orjuela C, Alvis-Guzmán N, Paternina AJ, et al. Cost-Effectiveness of the introduction of the pneumococcal polysaccharide vaccine in elderly Colombian population. Vaccine 2011;29:7644–50.9 Li X, Blais JE, Wong ICK, et al. Population-Based estimates of the burden of pneumonia hospitalizations in Hong Kong, 2011-2015. Eur J Clin Microbiol Infect Dis 2019;38:553–61.10 Jackson LA, Neuzil KM, Yu O, et al. Effectiveness of pneumococcal polysaccharide vaccine in older adults. N Engl J Med 2003;348:1747–55.11 Watson L, Wilson BJ, Waugh N. Pneumococcal polysaccharide vaccine: a systematic review of clinical effectiveness in adults. Vaccine 2002;20:2166–73.12 Moore RA, Wiffen PJ, Lipsky BA. Are the pneumococcal polysaccharide vaccines effective? meta-analysis of the prospective trials. BMC Fam Pract 2000;1:1.13 Conaty S, Watson L, Dinnes J, et al. The effectiveness of pneumococcal polysaccharide vaccines in adults: a systematic review of observational studies and comparison with results from randomised controlled trials. Vaccine 2004;22:3214–24.14 Webb BJ, Sorensen J, Mecham I, et al. Antibiotic use and outcomes after implementation of the drug resistance in pneumonia score in ED patients with community-onset pneumonia. Chest 2019;156:843–51.15 McCabe C, Kirchner C, Zhang H, et al. Guideline-concordant therapy and reduced mortality and length of stay in adults with community-acquired pneumonia: playing by the rules. Arch Intern Med 2009;169:1525.16 Rudan I, El Arifeen S, Bhutta ZA, et al. Setting research priorities to reduce global mortality from childhood pneumonia by 2015. PLoS Med 2011;8:e1001099.17 Buzzo AR, Roberts C, Mollinedo LG, et al. Morbidity and mortality of pneumonia in adults in six Latin American countries. Int J Infect Dis 2013;17:e673–7.18 Lewer D, Jayatunga W, Aldridge RW, et al. Premature mortality attributable to socioeconomic inequality in England between 2003 and 2018: an observational study. Lancet Public Health 2020;5:e33–41.19 Kaplan V, Angus DC, Griffin MF, et al. Hospitalized communityacquired pneumonia in the elderly: age- and sex-related patterns of care and outcome in the United States. Am J Respir Crit Care Med 2002;165:766–72.20 Vrbova L, Mamdani M, Moineddin R, et al. Does socioeconomic status affect mortality subsequent to hospital admission for community acquired pneumonia among older persons? J Negat Results Biomed 2005;4:1–8.21 Ahmad OB, Boschi-Pinto C, Lopez AD, et al. Age standardization of rates: a new who standard. GPE Discuss Pap Ser 2001:1–14.22 Kitagawa EM, Hauser PM. Differential mortality in the United States: a study in socioeconomic epidemiology. Cambridge, MA: Harvard Univ Press, 1973.23 Antonovsky A. Social class, life expectancy and overall mortality. Milbank Mem Fund Q 1967;45:31–73.24 Adler NE, Rehkopf DH. U.S. disparities in health: descriptions, causes, and mechanisms. Annu Rev Public Health 2008;29:235–52.25 Link BG, Phelan J. Social conditions as fundamental causes of disease. J Health Soc Behav 1995;Spec No:80–94.26 Phelan JC, Link BG, Diez-Roux A, et al. "Fundamental causes" of social inequalities in mortality: a test of the theory. J Health Soc Behav 2004;45:265–85.27 Everett BG, Rehkopf DH, Rogers RG. The nonlinear relationship between education and mortality: an examination of cohort, Race/Ethnic, and gender differences. Popul Res Policy Rev 2013;32:893–917.28 Oakes JM, Rossi PH. The measurement of Ses in health research: current practice and steps toward a new approach. Soc Sci Med 2003;56:769–84.29 Hummer RA, Lariscy JT. Educational attainment and adult mortality. In: International Handbook of adult mortality. Springer, 2011: 241–61.30 Braveman PA, Cubbin C, Egerter S, et al. Socioeconomic disparities in health in the United States: what the patterns tell us. 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