Past research has found that mortality is typically lower among those with a more advantageous socioeconomic position. The "fundamental causes" theory argues that it is the material and non-material resources associated with higher socioeconomic position, such as income, access to knowledge and social connections, that helps these individuals avoid disease, which leads to health inequalities. Johan P. Mackenbach and colleagues tested this theory to see if declines in mortality are greater among those with a higher socioeconomic position. To do so, they used mortality data from 20 European populations from 1980-2010 and were able to look at 22 specific causes of death, which they classified based on "preventability".
The authors found that in most causes of death, mortality declined faster among the higher educated. It was also found that when looking at "preventability", inequalities in mortality decline were larger for "preventable" deaths compared to "non-preventable" deaths.
However, in situations where there is an increase in mortality, the authors did not find that those with a higher education are better prepared to protect themselves. This is the case, for example, for hypertensive disease and colorectal cancer. One explanation suggested by the authors is that higher educated individuals are the ones that will first try to adopt new risk behaviours and products in an effort to maintain or improve their status. Even though these behaviours are bad for their health, their social status is improved, which was the case with smoking. The authors also found that despite inequalities in access to material resources, this is not a leading factor as to why those with a higher education benefit from opportunities for mortality decline. Inequalities in access to things like knowledge, social connections or cultural capital may actually be more important factors.