Socioeconomic differentials in mortality in Finland and the United States: the role of education and income

  • Irma T. Elo
  • Pekka Martikainen
  • Kirsten P. Smith


We document social inequalities in cause-specific mortality at ages 35–64 in Finland and the United States, countries with different health systems, income distributions, and social welfare programs for the working-aged population. The education–mortality gradient was the most marked for Finnish men and for causes of death linked to risk-taking, health behaviors, and stress. The association between family income and mortality was curvilinear in both countries. The effects of education and income were strongly attenuated after controlling for each other, marital status, and labor force participation, with the greatest attenuation observed for income in Finland and education in the United States.


Education Income Mortality Causes of Death Finland United States 


Cette étude concerne les inégalités en matière de mortalité spécifique par cause dans la tranche d’âge 35–64 ans en Finlande et aux Etats-Unis, deux pays qui diffèrent grandement de par leurs systèmes de soins, échelles de revenus, et politiques sociales en direction de la population d’âge actif. Le gradient de mortalité par niveau d’instruction était le plus accentué pour les hommes en Finlande, et pour les causes de décès liées aux comportements à risques, aux comportements de santé et au stress. L’association entre le revenu du ménage et la mortalité était curvilinéaire dans les deux pays. Les effets du niveau d’instruction et ceux du revenu étaient chacun fortement atténués après introduction de l’autre variable dans le modèle, et introduction du statut matrimonial et de la situation sur le marché du travail, la plus grande réduction étant observée pour le revenu en Finlande et pour le niveau d’instruction aux Etats-Unis.


niveau d’instruction revenu mortalité cause de décès Finlande Etats-Unis 


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This research was supported by a pilot project grant from the Population Aging Research Center (PARC), University of Pennsylvania, with funding from the National Institute on Aging (P30 AG12836). Pekka Martikainen was supported by the Academy of Finland (110498, 205634) and the Gyllenberg Foundation. Kristen Smith received support from a National Institute on Aging pre-doctoral training grant to the University of Pennsylvania (T32 AG000177) and the Social Science Research Council. We thank Hanna Rinne for programming assistance and help with the graphs, and anonymous reviewers for their comments on an earlier draft of this paper. An earlier version of this paper was presented at the annual meeting of the Population Association of America, April 2004.


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Copyright information

© Springer Science+Business Media B.V. 2006

Authors and Affiliations

  • Irma T. Elo
    • 1
  • Pekka Martikainen
    • 2
    • 3
  • Kirsten P. Smith
    • 4
  1. 1.Population Studies CenterUniversity of PennsylvaniaPhiladelphiaUSA
  2. 2.Population Research Unit, Department of SociologyUniversity of HelsinkiHelsinkiFinland
  3. 3.Helsinki Collegium for Advanced StudiesUniversity of HelsinkiHelsinkiFinland
  4. 4.Department of Health Care PolicyHarvard Medical SchoolBostonUSA

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