Why is the educational gradient in mortality steeper for men than women in the United States?

Jennifer Karas Montez, University of Texas at Austin
Mark D. Hayward, University of Texas at Austin
Dustin C. Brown, University of Texas at Austin

It is often documented that the educational gradient of mortality is steeper for men than women in the U.S., yet the explanation remains a matter of debate. We examine gender differences in the gradients within the context of marriage to determine whether they reflect gender differences in health behaviors or a greater importance of men’s education on married household mortality. We use the 1986-1996 National Health Interview Survey Linked Mortality Files. Results reveal that the steeper gradient for men overall reflects a steeper gradient among unmarried men, with low educated never married men exhibiting high levels of mortality. These men are more likely to die from causes for which smoking is a risk factor, supporting a behavioral explanation. No gender difference is observed for married adults. Low education and unmarried status exert a synergistic effect on men’s mortality. These men may disproportionately lack social supports that encourage positive health behaviors.