ArticleJournal of epidemiology and global health2026
Education Expands the Gender Gap in Blood Pressure in China: Evidence from a Comparative Analysis of Birth Cohorts.
Article in Journal of epidemiology and global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundChina has witnessed a greater increase in blood pressure across successive birth cohorts, especially among men, suggesting a widening gender gap in cardiovascular risk profiles. The expanded access to education since the mid-20th century and its differential impact on men’s and women’s cardiovascular health suggest that education may play an important role in this widening gender gap—a topic that remains under-explored.
objectiveThis study assessed the mediating effect of education years in the association between birth cohorts and systolic/diastolic blood pressure and examined whether this mediating effect varied by gender.
methodsData from the China Health and Nutrition Survey (1991–2015) were analyzed using multilevel moderated mediation analysis among adults born between 1950 and 1975.
resultsOur estimates indicated that (1) education years had a greater increase among women across cohorts. (2) Higher education years were associated with lower systolic/diastolic blood pressure in women, whereas men did not exhibit similar benefits. (3) Consequently, education years mediated the association between cohorts and systolic/diastolic blood pressure differently by gender. More specifically, improving education years curbed the upward cohort trend in systolic/diastolic blood pressure among women but not among men.
conclusionsEducation partially accounts for the widening gender gap in systolic/diastolic blood pressure across cohorts in China. Ensuring educational opportunities could potentially improve cardiovascular health for women. Factors that hinder men from achieving comparable cardiovascular health benefits from increased education years warrant further research.
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