Health behaviours, environment and social factors in the association between education and mortality
H Pikhart, A Dalecka, N Capkova, Y Pan, M BobakAbstract
Background
Early-life social conditions and education shape health across the life course, partly via their influence on health behaviours, adult social factors (such as social networks and participation), and a wide range of environmental and living conditions that jointly affect morbidity and mortality.
Methods
Using data from the Czech arm of the HAPIEE study, we estimated a structural equation model to examine the complex relationships between social, environmental, and behavioural factors across different life stages and mortality in a representative sample of middle- and older-aged adults. Lifestyle behaviours, environmental exposures (including air pollution and noise), urban characteristics, self-rated health, and later-life social factors such as loneliness were assessed as potential mediators.
Results
The analytic sample included more than 8,000 men and women aged 45–69 at baseline, with over 22 years of follow-up. Higher educational attainment was associated with lower mortality, whereas other early-life social conditions showed weaker associations. Several indirect pathways were identified, particularly through unhealthy behaviours. Small indirect pathways also linked education to mortality via environmental characteristics, especially for cardiovascular and respiratory deaths.
Conclusions
These findings underscore the importance of education, and support policies that maximise the benefits of education and promote healthy behaviours to reduce premature mortality in Central and Eastern Europe. Understanding these complex pathways can inform targeted interventions to support longevity and healthy ageing. #NGEU