An epidemiological study in South Korea has shown that education is a primary influence on mortality, in contrast to studies of more developed populations.

The researchers studied deaths in the South Korean working population aged 20–64 years, as recorded on the death certificates of the Korean National Statistics Office, and obtained information on occupation and education from next of kin. They derived denominators from a 10% stratified random sample from the 1995 census.

Their data covered 287 000 deaths in nearly 17 million people. Death rates adjusted for age were greater in manual versus non-manual occupations and with lower levels of education in men (1.65 v 1.00; 5.11 v 1.00 respectively) and women (1.48 v 1.00; 3.42 v 1.00 respectively).

The relation was abolished in men (1.65 v 0.94) and more or less in women (1.48 v 1.17 when rates were adjusted for sex and education, but remained similar when educational level was adjusted for occupation.

These class differences in deaths are greater than in the west. They may reflect a huge investment in education to assure national economic survival or may be a phenomenon that has already peaked and levelled off in western populations. However, the researchers are anxious not to overstate their case. “The effects of education predominate, but the close association of the two variables, and data limitations, suggest a cautious interpretation.”

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