Health inequalities in Korea: age- and sex-specific educational differences in the 10 leading causes of death

Background An ideological climate has persisted in Korea that has discouraged public discussion of social inequalities. Thus studies on inequalities in mortality remain undeveloped. This study is to examine age- and cause-specific socioeconomic mortality differentials for both men and women representative of the Korean population. Methods Using Korea's 1995 Census and 1995-2000 Death Certificate data, age-, sex-, and education-specific mortality rates were measured, after which education-specific rate ratios, and relative indices of inequality were calculated. Results Graded educational differentials in mortality were observed among both sexes with higher mortality rates related to lower educational attainment in most causes of death. However, positive associations were identified between education levels and mortality rates with respect to ischaemic heart disease among older males and breast cancer among older females. The magnitude of educational inequality in mortality was not constant across causes and in some cases differed by sex. Conclusions The changing relation between educational attainment and mortality rates from ischaemic heart disease and breast cancer likely reflects changes in the social distribution of risk factors that emerged in the process of Korea's rapid economic development. Studies on specific exposures over the life course influencing the occurrence of and survival after specific diseases would help provide a more complete understanding of patterns and trends in socioeconomic mortality differentials in Korea.