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New research published in Annals of Epidemiology examines why educational inequalities in life expectancy tend to be larger among men than among women — and how much of this difference can be explained by smoking, alcohol and obesity. The study, co-authored by LCDS researcher Daniel Zazueta-Borboa, analysed data from England and Wales, Finland, and Turin, Italy, covering trends from the early 1970s to 2017. The researchers focused on remaining life expectancy at age 30, comparing people with high and low levels of education.
Across all three populations, men generally experienced larger educational inequalities in life expectancy than women. Between 1992 and 2017, the sex gap in educational inequalities in remaining life expectancy at age 30 was 1.1 years in England and Wales, 2.6 years in Finland, and 2.4 years in Turin.
The study found that lifestyle-attributable mortality — deaths linked to smoking, alcohol and obesity — explained a substantial share of these sex differences. Removing these lifestyle-related deaths from the analysis reduced the sex gap in educational inequalities by 57% in England and Wales, 70% in Finland, and 92% in Turin. Smoking was the largest contributor overall, followed by alcohol, while obesity played a much smaller role.
The researchers also found important differences between countries. In Finland, alcohol-attributable mortality played a particularly important role and helped explain why the sex gap in educational inequalities began to decline after 2007. In England and Wales, the impact of smoking was smaller, reflecting the more advanced stage of the smoking epidemic. In Turin, where the smoking epidemic has followed a different timing, smoking made a particularly large contribution.
Daniel Zazueta-Borboa, Researcher at the Leverhulme Centre for Demographic Science, said:
“Our findings show that smoking and excessive alcohol consumption have played a major role in shaping why educational inequalities in life expectancy are larger among men than women. Reducing these inequalities will require prevention and treatment efforts that recognise both socio-economic disadvantage and gendered patterns in health behaviours.”
The findings highlight the importance of tackling smoking and excessive alcohol consumption as part of broader efforts to reduce health inequalities. The authors argue that targeted prevention and treatment, alongside action on the structural and material conditions that shape lifestyle choices, could substantially reduce socio-economic inequalities in life expectancy and narrow the gap between men and women.
The study was authored by Fanny Janssen, Daniel Zazueta-Borboa, Alison Sizer, Nicolas Zengarini and Pekka Martikainen and you can read more here: https://www.sciencedirect.com/science/article/pii/S1047279726001638
