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UW Professor Co-author of Study Explaining Education Gap in Mortality Among U.S. White Women

May 31, 2013
Anna Zajacova

Less-educated white women were more likely to die than better-educated females from the mid-1990s through the mid-2000s, according to a new study co-written by a University of Wyoming professor.

Anna Zajacova, a UW Department of Sociology assistant professor, and Jennifer Karas Montez, the study’s lead author and a Robert Wood Johnson Foundation Health and Society Scholar at Harvard University, combined on the project, "Explaining the Widening Education Gap in Mortality Among U.S. White Women.”

The study, which appears in the June issue of the Journal of Health and Social Behavior, relied on National Health Interview Survey Linked Mortality File statistics from 46,744 white women between the ages of 45-84 from 1997-2006.

For several years, growing mortality differences among white women were known among researchers. Increasing health inequalities were observed in much of the population, but the mortality trends among white women had a particularly disturbing feature, Zajacova says.

“The least-educated white women, during the 1980s and 1990s, began to live shorter lives -- an unprecedented longevity decline that contradicted a broad, sweeping increase in life expectancies during the 20th century in most populations,” she says.

Montez and Zajacova found that growing disparities in economic circumstances and health behaviors -- especially employment status and smoking habits from various education levels -- accounted for a major portion of the widening mortality gap. Their research found that social-psychological factors contributed little to the increasing gap, but economic circumstances and health behaviors played important roles.

In their study, the two researchers divided the women into two groups -- females without a high school credential (lower educated) and women who at least graduated from high school (higher educated). Montez and Zajacova noted that the odds of dying among the lower-educated white women group were 37 percent greater than among their higher-educated peers during 1997-2001, and 66 percent greater during 2002-2006.

Zajacova says little research was done in the past to figure out the disturbing mortality trends among white women. And, in the few published studies on the topic, researchers tried to explain the trends by focusing on individual behaviors -- specifically smoking. However, this focus excluded the broad economic changes in U.S.  society since the 1970s or 1980s, which included growing employment and income inequalities.

The two researchers wanted to include these broad changes in examining what was happening to the least-educated women, and not just focus on their individual behaviors.

“This broader focus is critical if we want to design social policies to reverse the growing inequalities,” Zajacova says.

The research noted that throughout the 1980s and 1990s, inequalities by education grew in the United States: Those with less education increasingly had relatively less stable and lower-paying jobs compared to those with more education; and smoking was increasingly concentrated among those with the least schooling.

“These changes occurred for most demographic groups and resulted in growing health inequalities for the whole population, but they seemed to impact white women particularly strongly,” Zajacova says. “Among white women with the least education, an unprecedented trend occurred: They began dying younger. This is contrary to a century of systematically increasing life spans in most population in most countries across the globe, an unusual trend that was bound to attract research and policy attention.”

In their study, the two researchers looked at eight components of economic circumstances -- employment, occupation, poverty, home ownership, health insurance and health behaviors, smoking, obesity and alcohol consumption. They said employment and smoking were by far the most important contributors to the widening mortality gap.

“How did we see in the data that employment and smoking were the most important contributors? We knew numerous characteristics of all the women in the study, such as their marital status, their psychological state, whether they consumed alcohol, etc.,” Zajacova says.

She adds that the women’s different marital situations or alcohol use did not have much effect on the mortality trends. However, as their research took into account the women’s employment status and smoking, the mortality trends decreased.

“That is, the less-educated women were less likely to be employed and more likely to smoke than those with more schooling; when we took this information into account, we explained the growing mortality disparities,” Zajacova says. “Now, perhaps the question is why these two factors played such a prominent role. This may be because both employment and smoking happen to be important for one’s health and longevity. At the same time, the more- versus less-educated white women became more dissimilar in employment and smoking patterns over time, so these two important factors increasingly differentiated the healthier, more-educated white women from the less-educated ones.”

Zajacova and Montez and have known each other for several years since meeting at the Austin Population Research Center at the University of Texas.

“When we realized how similar our research interests are, we began collaborating about a year ago. We found we work great together and have several projects under way,” Zajacova says.

Before coming to UW in 2009, she was a postdoctoral fellow at the University of Michigan. Zajacova completed her doctoral degree in sociology and demography at Princeton University in 2006.

Her field of work at UW focuses on population health, and among her other research, is studying health inequalities and the obesity epidemic.

For more information, contact Zajacova at (307) 766-6552 or email

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