Various aspects of socioeconomic conditions in the neighbourhood have in recent years been found to have an influence on morbidity and mortality even after individual characteristics are taken into account.¹ Increasing evidence suggests that to measure fully the impact social conditions may have on mortality risk, the whole life course must be taken into account as mortality risk increases cumulatively over the life course.² Few studies have combined ecological and life course factors to see if contextual effects may be explained by social conditions earlier in life at the individual level.^3,4 Most studies of neighbourhood effects have had a cross sectional design or with short follow up. Effects seen could be a consequence of the fact that people in these areas may have different earlier life experiences that have not been fully taken into account. In this study we examine whether the contextual effect of educational level aggregated to the neighbourhood on mortality risk could be explained by earlier life deprivation.

METHODS AND RESULTS

A cohort of all inhabitants in Oslo aged 30–69 years in 1990 was linked to the censuses in 1960 to 1990, the Educational Register in 1990, and the Death Register 1990 to 1998. There were 131 985 people 30–49 years (29% excluded) and 87 533 50–69 years (20% excluded). Education was defined as primary education (7–9 years), middle school (10–11 years), secondary school (12 years), college (12–16 years), and university (over 16 years). Altogether 473 neigbhourhoods were registered at the census in 1990 to administer elections. …