Overqualification and risk of all-cause and cardiovascular mortality: evidence from the Canadian census mortality follow-up study

Objectives: To evaluate whether education, occupation and overqualification (defined as having a level of educational attainment higher than the skill level required for an occupation) are associated with risk of all-cause and cardiovascular disease (CVD) mortality.Method: A prospective study of the association between overqualification and all-cause and CVD mortality was undertaken in the Canadian Census Mortality Follow-up study (1991-2001), a 15% sample of Canadian adults who completed the 1991 census long-form questionnaire (n=1,091,800, 39% women, baseline age 35-64 years). Education, occupation and all confounders (age, income adequacy, marital status, years since immigration, ethnicity, Aboriginal origins, province of residence, and community size) were measured at study baseline, with subsequent follow-up for mortality.Results: Sex-specific age-adjusted Cox proportional hazards models showed an inverse association between education and all-cause mortality (women: hazard ratio (HR)=1.55, 95% confidence interval (CI): 1.45-1.66; men: HR=1.94, 95% CI: 1.87-2.01, for