Do third grade school marks predict total and cause-specific mortality? A life long follow-up of Swedish children born in 1915-29

Much resent research has pointed to an association between childhood cognitive ability (IQ) and mortality risk in middle and old age. Although achieved education is a well-known determinant of adult health, considerably fewer studies have considered the role of school performance on later-life mortality risk. School marks probably reflect a broader spectrum of skills than do IQ. This study investigates the gender-specific importance of third grade school marks in arithmetics and Swedish for all-cause and circulary disease mortality across the whole adult life-course before and after adjustment for social conditions in child- and adulthood, including achieved education. A sample of 7,350 individuals who were born at Uppsala University Hospital in 1915-29 and who attended 3rd grade within the Uppsala school district are analyzed. As far as we know these are the earliest data on school marks/cognitive ability hitherto and by far the most complete follow-up of a well-defined birth cohort. Results: there was a significantly lower all-cause, circulatory and IHD mortality risk among men with top-marks in arithmetic compared to men with average arithmetic-marks. For women, a significantly higher all-cause, circulatory and stroke mortality risk was found among those with the lowest marks in arithmetic when compared to those with average marks, both in the crude and the adjusted model. For marks in Swedish, on the other hand, no significant relationship with later life mortality was found, neither for men nor women. Conclusion: third grade school marks in arithmetic is a considerably better predictor of adult and old age overall and circulatory mortality risk than third grade marks in Swedish in this cohort born in early twentieth century Sweden. Finally, there was no indication that the overall association between third grade school marks and later mortality was more prominent among men than among women.