The Spillover Influence of Partner's Education on Myocardial Infarction Incidence and Survival.

BACKGROUND: Education is believed to have positive spillover effects across network connections. Partner's education may be an important resource preventing the incidence of disease and helping patients cope with illness. We examined how partner's education predicted myocardial infarction (MI) incidence and survival net of own education and other socioeconomic resources in Finland.

METHODS: A sample of adults aged 40-69 years at baseline in Finland in 1990 was followed up for MI incidence and mortality during the period 1991-2007 (n = 354,100).

RESULTS: Lower own and spousal education both contributed independently to a higher risk of MI incidence and fatality when mutually adjusted. Having a partner with basic education was particularly strongly associated with long-term fatality in women with a hazard ratio of 1.53 (95% confidence interval, 1.22-1.92) compared with women with tertiary level educated partners. There was some evidence that the incidence risk associated with basic spousal education was weaker in those with own basic education. The highest risks of MI incidence and fatality were consistently found in those without a partner, whereas the most favorable outcomes were in households where both partners had a tertiary level of education.

CONCLUSIONS: Accounting for spousal education demonstrates how health-enhancing resources accumulate to some households. Marriage between people of similar educational levels may therefore contribute to the widening of educational differences in MI incidence and survival.