Young adults from low socioeconomic backgrounds face an increased risk of early mortality. Here we utilize population-wide data from 17 Norwegian birth cohorts (N = 986,573) to assess whether this risk gradient was explained by early-life educational performance, specifically grade point average at 16 years of age. We show that the gradients in both parental education and income largely disappeared when adjusting for school performance in the models. Specifically, among boys, those with the lowest parental education had an unadjusted hazard ratio (HR) of 2.04 (95% confidence interval (CI) 1.86–2.22) compared with peers with the highest parental education, while for girls, the HR was 1.64 (95% CI 1.35–1.93). After adjusting for school performance, these estimates dropped to 0.99 (95% CI 0.79–1.19) for boys and 0.87 (95% CI 0.55–1.19) for girls. Similarly, the mortality risk for those from the lowest parental income quartile decreased from 1.79 (95% CI 1.67–1.91) to 1.25 (95% CI 1.12–1.38) for boys and from 1.63 (95% CI 1.44–1.83) to 1.24 (95% CI 1.03–1.46) for girls. Low educational performance remained strongly associated with early mortality in analyses accounting for unobserved heterogeneity at the family level; boys with a grade point average in the lowest quartile had an HR of 3.04 (95% CI 2.38–3.89), while for girls, the HR was 1.79 (95% CI 1.22–2.63). External causes of death, particularly accidents and poisoning, were most overrepresented among individuals with poor school performance.

来自低社会经济背景的年轻人面临更高的早期死亡风险。在这里，我们利用来自 17 个挪威出生队列 （N = 986,573） 的全人口数据来评估这种风险梯度是否由早期教育表现解释，特别是 16 岁时的平均绩点。我们表明，在模型中调整学校表现时，父母教育和收入的梯度在很大程度上消失了。具体来说，在男孩中，与父母受教育程度最高的同龄人相比，父母受教育程度最低的人的未经调整的风险比 （HR） 为 2.04 （95% 置信区间 （CI） 1.86-2.22），而女孩的 HR 为 1.64 （95% CI 1.35-1.93）。在调整学校表现后，这些估计值下降到男孩的 0.99 （95% CI 0.79-1.19） 和女孩的 0.87 （95% CI 0.55-1.19）。同样，来自父母收入最低四分位数的人的死亡风险从男孩的 1.79 （95% CI 1.67-1.91） 下降到 1.25 （95% CI 1.12-1.38），女孩从 1.63 （95% CI 1.44-1.83） 下降到 1.24 （95% CI 1.03-1.46）。在解释家庭水平未观察到的异质性的分析中，低教育表现仍然与早期死亡率密切相关;平均绩点在最低四分位数的男孩的 HR 为 3.04 （95% CI 2.38-3.89），而女孩的 HR 为 1.79 （95% CI 1.22-2.63）。死亡的外部原因，尤其是事故和中毒，在学习成绩不佳的个体中所占比例最高。