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July 1, 2025

Education levels may affect mortality trends

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Researchers are examining the factors linked to higher-than-expected mortality rates in recent years.   

PeopleImages.com - Yuri A / Shutterstock

The average American today can expect to live longer than their great-grandparents did. But after decades of improvement, in the last 15 years U.S. mortality rates have leveled off or worsened. A range of factors can influence overall health and life expectancy. Notably, research has found that mortality is lower among people with a higher level of education.

In a new study, researchers led by Dr. Andrew Stokes at Boston University School of Public Health examined U.S. mortality rates by educational attainment before, during, and after the COVID-19 pandemic. They wanted to know whether recent death rates differed from what might be expected based on earlier trends.

The team used data from the CDC’s National Center for Health Statistics and the U.S. Census Bureau, including data on more than 47 million deaths. They first computed age- and cause-specific mortality rates among adults aged 35 and older by sex and educational attainment. For the latter, they computed mortality rates for people who had and had not earned bachelor’s degrees.. Using mortality trends from 2006-2010, they calculated expected mortality rates for 2011-2023. They then compared these with the actual mortality rates. Results were reported in JAMA Health Forum on June 13, 2025.

The team found higher mortality than expected after 2011. In 2023, there were 525,505 excess deaths in total. Among those without a bachelor’s degree, there were more than 480,000 excess deaths, 26% higher than anticipated. Among those with a bachelor’s degree, there were about 44,000 excess deaths, 8% higher than anticipated.

COVID-19 was a leading cause of excess deaths between 2020 and 2023. But much of the increase in excess deaths was associated with increases in deaths from circulatory diseases and diabetes. In 2023, circulatory diseases and diabetes were top causes of excess death among both men and women who didn’t graduate from college. Deaths from drug poisonings also increased, especially among men without a college degree.

“The United States is facing a crisis of deteriorating mortality that is largely falling on the shoulders of those with less education,” Stokes says. “Living in rural areas, having a lack of access to healthy foods and good nutrition, working in precarious employment sectors—these are the things that make it difficult to eat well, sleep well, and exercise. Education fundamentally structures people’s work opportunities, and having less of it sets people up for a lot of downstream consequences that make it difficult to maintain good health.”

The authors note that the study had limitations. For example, more adults graduated from college in 2023 than in 2006. As a result, adults without a college degree are relatively more disadvantaged than they would have been in the earlier period. It will be important to closely study the specific factors underlying these trends to confirm these results and improve understanding of how education is associated with Americans’ health.

—by Kendall K. Morgan, Ph.D.

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References

. Paglino E, Wrigley-Field E, Stokes AC. JAMA Health Forum. 2025 Jun 7;6(6):e251647. doi: 10.1001/jamahealthforum.2025.1647. PMID: 40512512.

Funding

51��Ƶ’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); W. K. Kellogg Foundation.