TY - JOUR T1 - Reversals in past long-term trends in educational inequalities in life expectancy for selected European countries JF - Journal of Epidemiology and Community Health JO - J Epidemiol Community Health DO - 10.1136/jech-2023-220385 SP - jech-2023-220385 AU - Jesus Daniel Zazueta-Borboa AU - Pekka Martikainen AU - Jose Manuel Aburto AU - Giuseppe Costa AU - Riina Peltonen AU - Nicolas Zengarini AU - Alison Sizer AU - Anton E Kunst AU - Fanny Janssen Y1 - 2023/04/26 UR - http://jech.bmj.com/content/early/2023/05/11/jech-2023-220385.abstract N2 - Background Across Europe, socioeconomic inequalities in mortality are large and persistent. To better understand the drivers of past trends in socioeconomic mortality inequalities, we identified phases and potential reversals in long-term trends in educational inequalities in remaining life expectancy at age 30 (e30), and assessed the contributions of mortality changes among the low-educated and the high-educated at different ages.Methods We used individually linked annual mortality data by educational level (low, middle and high), sex and single age (30+) from 1971/1972 onwards for England and Wales, Finland and Italy (Turin). We applied segmented regression to trends in educational inequalities in e30 (e30 high-educated minus e30 low-educated) and employed a novel demographic decomposition technique.Results We identified several phases and breakpoints in the trends in educational inequalities in e30. The long-term increases (Finnish men, 1982–2008; Finnish women, 1985–2017; and Italian men, 1976–1999) were driven by faster mortality declines among the high-educated aged 65–84, and by mortality increases among the low-educated aged 30–59. The long-term decreases (British men, 1976–2008, and Italian women, 1972–2003) were driven by faster mortality improvements among the low-educated than among the high-educated at age 65+. The recent stagnation of increasing inequality (Italian men, 1999) and reversals from increasing to decreasing inequality (Finnish men, 2008) and from decreasing to increasing inequality (British men, 2008) were driven by mortality trend changes among the low-educated aged 30–54.Conclusion Educational inequalities are plastic. Mortality improvements among the low-educated at young ages are imperative for achieving long-term decreases in educational inequalities in e30.Data may be obtained from a third party and are not publicly available. The secondary data that we used as input for our analyses cannot be made publicly available, because the institutes that own the data apply a restricted access policy. The specific output that was used to create the main tables and the figures can be obtained through Open Science Framework (https://osf.io/tk4nw/). The R code(s) can be requested from the first author. ER -