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Because of the value that individuals place on health and longevity, levels of mortality are among the most central indicators of social and economic well-being. Analysts are concerned not only with the average level of mortality but also with its distribution among social groups, which is a fundamental indicator of social inequality. The principal dimension on which these assessments are now made in the United States is educational attainment. The decisive shift from occupational groups, the classic dimension used by the Registrar-General of England and Wales, to educational groups as the basis for assessment occurred with the publication of Kitagawa and Hauser's (1973) major study of American mortality differentials in 1960. Educational attainment has two main advantages relative to occupation and income, the other common indicators of social stratification. It is available for people who are not in the labor force; and its value is less influenced by health problems that develop in adulthood. Since health problems can lead to both high mortality and low income, comparisons of death rates of different income groups, for example, are biased by their mutual dependence on a third variable, the extent of ill health. For these reasons, educational attainment has become the principal social variable used in epidemiology as well as in demography (Liberatos et al. 1988).
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