In many countries education rather than social class is used as the standard indicator of socioeconomic position. When it is used in this way, education levels produce a gradient in mortality similar to that produced by social class. The most advantaged individuals in terms of education have the lowest mortality rates, and mortality rates tend to increase in a stepwise fashion as individuals become more educationally disadvantaged. Table 10.1 illustrates this stepwise gradient with recent data for adults of working age in the United States. In 1989-90 those who had received sixteen years or more of formal education had the lowest mortality rates, while those who had received nine to eleven years had the highest rates (NCHS 1994). Other studies in the United Stares confirm the inverse relationship between education and mortality and suggest that the disparity in death rates of the well and poorly educated has increased in recent decades (Rogot et al. 1992; Pappas et al. 1993).