Educational inequalities in ischaemic heart disease mortality in 44,000 Norwegian women and men: The influence of psychosocial and behavioural factors. The HUNT Study

Aims: To investigate the influence of psychosocial and behavioural factors on educational inequalities in ischaemic heart disease (IHD) mortality. Methods: A population-based cohort study of 44,128 women and men free of IHD aged 30 years and older at baseline in 1995-97. Results: After adjustment for age and long-standing illness, both women (HR 3.22, 95% CI 1.31-7.90) and men (HR 1.57, 95% CI 1.03-2.40) who completed only primary education level (primary and lower secondary school) were at increased risk for IHD mortality compared to those who completed the tertiary education level (first and second stage of tertiary education). Behavioural factors explained 25% of the relative difference between primary and tertiary education level in IHD mortality among women and 53% in men. Psychosocial factors had small influence on the relative difference in IHD mortality Conclusions: Findings from this study indicate that differences in behavioural factors contribute considerably more to inequalities in IHD mortality in educational levels than do psychosocial factors, and this effect seems to be stronger in men than women.