Educational Attainment and Child and Adult Mortality in Sierra Leone: A Nationally Representative Mortality Study, 2019-2024

Background: Education and mortality are strongly correlated. However, little is known about the relationship between education and adult mortality and causes of death in low- and middle-income countries. We examined mortality rates and cause-specific mortality in all age groups, by education level, in Sierra Leone, a low-income country in West Africa.

Methods: We used nationally representative household and mortality data for 2019-2024 from the Sierra Leone Sample Registration System (HEAL-SL), which covers 5% of the population using household interviews and electronic verbal autopsies (e-VAs). We calculated all-cause and cause-specific mortality rates by age at death and sex, and education level of household head, using cause-of-death data from HEAL-SL and population and mortality data from the United Nations World Population Prospects 2022 and UNICEF.

Findings: For almost all age groups and causes of death, mortality rates were highest in families with low education levels and lowest in those with higher education levels, with notable exceptions. The opposite pattern was true for neonates: mortality was lowest in low-education households and highest in higher-level education households. Similarly, for older adults, cardiovascular mortality increased with household education level. Mortality rates for malaria, the leading cause of death at all ages except neonates, decreased sharply with increasing education among children, but was similar among adults regardless of education level.

Interpretation: Household level of education as a proxy for level of prosperity and wellbeing is a strong predictor of mortality across age groups and in both sexes in Sierra Leone. These findings reinforce the importance of nationwide mortality studies in low-income countries.

Note:
Gates Foundation Grant Number(s): PENDING

Data Availability Statement: The Healthy Sierra Leone (HEAL-SL) datasets are available online at www.npha.sl.org and via www.openmortality.org.

Keywords: Sierra Leone, Mortality, Education, Child mortality, Adult Mortality, Educational Attainment and Mortality

Suggested Citation: Suggested Citation

Wu, Daphne and Meh, Catherine and Sahr, Foday and Ikoona, Eric and Assalif, Anteneh and Carshon-Marsh, Ronald and Bockarie, Tahir and Essue, Beverley M. and Ansumana, Rashid and Gelband, Hellen and Jha, Prabhat, Educational Attainment and Child and Adult Mortality in Sierra Leone: A Nationally Representative Mortality Study, 2019-2024. Available at SSRN: https://ssrn.com/abstract=5336402 or http://dx.doi.org/10.2139/ssrn.5336402