Objectives: to evaluate socioeconomic inequalities in mortality by educational level in Italy.
Design: cohort study based on the record linkage between the 2012-2014 archives of mortality and the 2011 Italian population Census.
Setting and participants: Italian population registered in the 2011 Census.
Main outcome measures: life expectancy by educational level, age-standardized mortality rates, mortality rate ratios (MRRs) for overall mortality, and 12 groups of causes of death.
Results: life expectancy at birth was 80.3 years among men and 84.9 among women. High-educated men were expected to live 3 years longer than lower educated men, while the gap was narrower in women (1.5 years). Lower educated men had a higher mortality from any cause (MRR: 1.34; 95%CI 1.33-1.35) with larger differentials for lung, upper aerodigestive, and liver cancers, respiratory system diseases, AIDS and accidents. Socioeconomic inequalities were larger in the North-West of the Country for lung and liver cancer. Educational inequalities were smaller among women for all-cause mortality, but remarkably larger for circulatory system diseases (MRR: 1.40; 95%CI 1.38-1.42), particularly in the South (MRR: 1.46; 95%CI 1.42-1.50).
Conclusions: this study documented socioeconomic inequalities in mortality in Italy for many causes of death; some of them resulted heterogeneous by area of residence. Most of the inequalities can be counteracted with specific measures aimed to improve behavioural risk factors among less educated people.