Human Capital and Avoidable Mortality across Serbian Municipalities: A Spatial-Ecological Analysis

Abstract

There is a strong association between education and mortality. However, the relationship between education and avoidable mortality is understudied in Serbia. In this study, data on education from the 2022 Census and vital statistics covering 2015–2019 are combined to examine whether human capital at the municipality level is associated with avoidable mortality (amenable and preventable) across 162 municipalities. Education was measured by age/sex standardized mean number of years of schooling of persons aged 25+. Mortality was classified with avoidable cause lists and age-standardized. Descriptive mapping was conducted, spatial autocorrelation was tested, mortality was assessed using Moran’s I index, and log-mortality models were estimated with ordinary least squares and spatial econometrics techniques. Residuals, Lagrange-multiplier tests, likelihood-ratio tests, information criteria, and parsimony were used in modeling decisions. Amenable and preventable mortalities were studied by estimating a stacked mixed-effects model with municipality-level random intercepts. Education and avoidable mortality have a strong regional component in Serbia, but the cores of both phenomena did not match. Higher standardized mean years of schooling were concentrated near major cities, while avoidable mortality was high in the northern parts of Vojvodina. Once adjusted for region and degree of urbanization, municipal education was significantly negatively associated with mortality. A one-year higher age/sex standardized mean schooling level was associated with an approximately 10% reduction in the rate of avoidable mortality, which was the most pronounced for amenable and the weakest for preventable deaths. For Serbia, higher area-level education is most strongly associated with mortality sensitive to healthcare intervention.

BibTeX

@article{galjak_human_2026,
  title = {Human {Capital} and {Avoidable} {Mortality} across {Serbian} {Municipalities}: {A} {Spatial}-{Ecological} {Analysis}},
  shorttitle = {Human {Capital} and {Avoidable} {Mortality} across {Serbian} {Municipalities}},
  issn = {0350-7599, 1821-2808},
  url = {https://doi.org/10.2298/IJGI260618020G},
  doi = {10.2298/IJGI260618020G},
  language = {en},
  journal = {Journal of the Geographical Institute Jovan Cvijic, SASA},
  author = {Galjak, Marko and Budić, Marina},
  month = oct,
  year = {2026},
  keywords = {avoidable mortality, human capital, education, municipal inequalities, Serbia},
}