Inequalities in life expectancy in Australia according to education level: A
whole-of-population record linkage study
Authors: Welsh J , Bishop K , Booth H , Butler D , Gourley M , Law HD , Banks E , Canudas Romo V , Korda RJ 
Published: March 2021

Abstract

Objective
Life expectancy in Australia is amongst the highest globally, but
national estimates mask within-country inequalities. We estimate
education-related inequalities in adult life expectancy in
Australia.

Design and setting
We estimated age-sex-education specific mortality rates using data from
2016 Australian Census linked to 2016-17 Death Registrations and standard
life table methodology to calculate life expectancy.

Participants
14,565,910 Australian residents aged 25 years and older.

Main outcome measure
Absolute (in years) and relative (ratios) differences in life expectancy
at ages 25, 45, 65 and 85 years by sex and education level (5 levels, from
Bachelor’s degree or higher [highest] to no secondary or post-secondary
qualification [lowest]).

Results
At each age, those with lower education had shorter life expectancies.
For men, the gap (highest vs lowest education) was 9.1 (95%CI: 8.8, 9.4)
years at age 25, 7.3 (7.1, 7.5) years at age 45, 4.9 (4.7, 5.1) years at age
65 and 1.9 (1.8, 2.1) years at age 85. Absolute gaps were smaller for women
compared with men but remained substantial: 5.5 (5.1, 5.9) years at age 25,
4.7 (4.4, 5.0) years at age 45, 3.3 (3.1, 3.5) years at 65 and 1.6 (1.4,
1.8) years at age 85. Relative differences were larger for men and increased
with age.

Conclusion
Education-related inequalities in life expectancy from age 25 years in
Australia are substantial such that those with the lowest education have a
life expectancy equivalent to the national average 15-20 years ago. These
vast gaps indicate large potential for further population health
gains.

The known
Life expectancy in Australia has increased over time and is now
among the highest in the world, but national estimates mask
within-country inequalities and further potential for health gain.
Area-level socioeconomic inequalities in health are well documented
in Australia, but life expectancy gaps by individual-level
socioeconomic position (e.g. highest level of education), a powerful
measure of health inequality, have not been routinely
available.

The new
Newly-available national linked data – 2016 Australian Census
linked to Death Registrations (2016-17) – show that at each age
(from age 25 years), men and women with lower levels of education,
have shorter life expectancies. At age 25 years, the life expectancy
gap between those with no educational qualifications and those with
a university degree was 9.1 years for men and 5.5 years for women.
Given lower life expectancy among men than among women, this
represents a much larger relative – as well as absolute – gap for
men.

The implications
Education-related gaps in life expectancy are considerable,
larger than the OECD average, and mean that those with the lowest
education have a life expectancy equivalent to the national average
15-20 years ago. The gaps indicate large potential for further
improvements in population health, and health equity.