Educational status and life expectancy in patients with chronic non-communicable diseases

Main Article Content

Liliana del Sagrario Villarreal-Hernández
Jesús Eduardo Romo-Martínez

Keywords

Education, Diabetes mellitus, Cardiovascular diseases

Abstract

Background: Suffering a non communicable chronic disease in combination with low educational level and low economic income develops a synergy, which contributes to a poor prognostic about the expectancy of life. A better educational level may improve the life expectancy. The objective of this research was to explore this relation.

Methods: A retrospective cohort study from January 1, 1999, to December 31, 2011, was performed. We included 2306 patients obtained from the information system in mortality of Family Medicine Unit 3 of the Instituto Mexicano del Seguro Social in Guadalajara, Jalisco. The main measures were average age-at-death and educational level. We used Student’s t, chi-squared test and relative risk (RR) calculations for statistical analysis.

Results: The average age-at-death for those who had a low educational level (n = 1936) was 73.24 ± 12.18 years, while for those who had a satisfactory level of education (n = 370) was 63.47 ± 14.51 years, estimating a mean difference of 9.77 years with p < 0.001. Having a low educational level and not reaching life expectancy compared to the satisfactory level meant a RR = 0.24 (IC 95 % = 0.19, 0.30). The projected linear regression for each educational grade showed that patients lost 2.5 years of life.

Conclusions: Diabetes accompanied by a low educational level showed a double probability of not reaching the expectation of life.

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References

Constitución Política de los Estados Unidos Mexicanos. Título Primero Capítulo I. De los derechos humanos y sus garantías (cambio de denominación, mediante decreto publicado en el Diario Oficial de la Federación del 10/06/ 2011). Texto libre en http://info4.juridicas.unam.mx/ijure/fed/9/2.htm?s=



Cámara de Diputados del H. Congreso de la Unión. Ley general de educación. Diario Oficial de la Federación del 11/09/2013. Texto libre en http://www.diputados.gob.mx/LeyesBiblio/pdf/137.pdf



United Nations Development Program. Indicadores internacionales sobre desarrollo humano: informes nacionales sobre desarrollo humano para México. México: UNDP; 2011. Texto libre en http://hdrstats.undp.org/es/paises/perfiles/MEX.html



Instituto Nacional de Estadística y Geografía. [Sitio web]. México en cifras: información nacional, por entidad federativa y municipios; Estadística. INEGI: Defunciones generales 2011. Disponible en http://www3.inegi.org.mx/sistemas/mexicocifras/default.aspx



Murray CJ, Salomon J, Mathers C. A critical examination of summary measures of population health. Bull World Health Organ. 2000;78(8):981-94. Texto libre en http://www.who.int/healthinfo/paper02.pdf



Manuel DG, Schultz SE, Kopec JA. Measuring the health burden of chronic diseases and injury using health adjusted life expectancy and the Health Utilities Index. J Epidemiol Community Health. 2002;56 (11):843-50.



Murray CJ, López AD. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet. 1997;349(9064): 1498-504.



Yach D, Hawkes C, Gould CL, Hofman KJ. The global burden of chronic diseases: Overcoming impediments to prevention and control. JAMA. 2004;291 (21):2616-22.



Smith GD, Blane D, Bartley M. Explanations for socioeconomic differentials in mortality. Evidence from Britain and elsewhere. Eur J Public Health. 1994;4 (2):131-44.



Kalediene R, Petrauskiene J. Inequalities in life expectancy in Lithuania by level of education. Scand J Public Health. 2000;28(1):4-9.



Kunst AE, Mackenbach JP. Measuring socio-economic inequalities in health. Copenhagen: WHO; 1993.



Smith GD, Egger M. Socioeconomic differences in mortality in Britain and the United States. Am J Public Health. 1992;82(8):1079-80.



Singh GK, Siahpush M. Widening socioeconomic inequalities in US life expectancy, 1980-2000. Int J Epidemiol. 2006;35(4):969-79.



Katz S, Greer DS, Beck JC, Branch LG, Spector WD. Active life expectancy: Societal implications. En: Committee on an Aging Society. Health in an older society. Washington, D.C., US: National Academy Press; 1985. p. 57-72.



Olshansky SJ, Passaro DJ, Hershow RC, Layden J, Carnes BA, Brody J, et al. A potential decline in life expectancy in the United States in the 21st century. N Engl J Med. 2005;352(11):1138-45.



Sikdar KC, Wang PP, MacDonald D, Gadag VG. Diabetes and its impact on health-related quality of life: A life table analysis. Qual Life Res. 2010;19(6):781-7.



Beltrán-Sánchez H, Preston SH, Canudas-Romo V. An integrated approach to cause-of-death analysis: Cause-deleted life tables and decompositions of life expectancy. Demogr Res. 2008;19(35):1323-50.



Wagstaff A, Paci P, van Doorslaer E. On measurement of inequalities in health. Soc Sci Med. 1991;33 (5):545-57.



Arriaga EE. Measuring and explaining the change in life expectancies. Demography. 1984;21(1):83-96.



Cristia JP. Rising mortality and life expectancy differentials by lifetime earnings in the United States. J Health Econ. 2009;28(2):984-8



Bonita R, Beaglehole R, Kjellström. Epidemiología básica. Segunda edición. Washington, D. C: OPS; 2008. Disponible en http://iris.paho.org/xmlui/bitstream/handle/123456789/3153/Epidemiolog%C3 %ADa%20b%C3%A1sica.pdf?sequence=1



García L, Nolasco A, Bolumar F, Álvarez C. Los años potenciales de vida perdida: una forma de evaluar las muertes prematuras. Med Clin (Barc). 1986;87(2):55-7.



Centro Mexicano para la Clasificación de Enfermedades. Guía para el llenado de los certificados de defunción y del certificado de muerte fetal: México: Secretaría de Salud; 2004. Texto libre en http://www.salud.gob.mx/unidades/cdi/documentos/DOCSAL7761.pdf



Gnavi R, Petrelli A, Demaria M, Spadea T, Carta Q, Costa G. Mortality and educational level among diabetic and non-diabetic population in the Turin Longitudinal Study: A 9-year follow-up. Int J Epidemiol. 2004;33(4):864-71.



Feldman JJ, Makuc DM, Kleinman JC, Cornoni-Huntley J. National trends in educational differentials in mortality. Am J Epidemiol. 1989;129(5):919-33.



Kautzky-Willer A, Dorner T, Jensby A, Rieder A. Women show a closer association between educational level and hypertension or diabetes mellitus than males: A secondary analysis from the Austrian HIS. BMC Public Health. 2012;12:392. Disponible en http://www.biomedcentral.com/1471-2458/12/392



Dray-Spira R, Gary-Webb T, Brancati F. Educational disparities in mortality among adults with diabetes in the U.S. Diabetes Care. 2010;33(6):1200-05. Texto libre en http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2875423/



Miech R, Pampelb F, Kimc Jm, Rogersb RG. The enduring association between education and mortality the role of widening and narrowing disparities. Am Sociological Rev. 2011;79:913-34.