Contributors: Department of Health Sciences; Malmö University Hospital,-Skane University Hospital Lund; Department of Clinical Sciences; Malmö University Hospital-Skane University Hospital Lund; ESIM - Déterminants Sociaux de la Santé et du Recours aux Soins (DS3); Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM); Department of Epidemiology, Biostatistics and Occupational Health Montréal; McGill University = Université McGill Montréal, Canada; This investigation was supported by a ALF Government Grant Dnr M:B 39923/2005 (Maria Rosvall), by a postdoctoral grant from Le Fondation pour la Recherche Médicale (Basile Chaix), by a ALF Government Grant Dnr M:B 1003/2004 (Martin Lindström), by the Swedish Council for Working Life and Social Research (PI Juan Merlo, Dnr: 2003 - 05809) and the Swedish Research Council (PI Juan Merlo, Dnr 2004-6155)
نبذة مختصرة : BACKGROUND: To more efficiently reduce social inequalities in mortality, it is important to establish which causes of death contribute the most to socioeconomic mortality differentials. Few studies have investigated which diseases contribute to existing socioeconomic mortality differences in specific age groups and none were in samples of the whole population, where selection bias is minimized. The aim of the present study was to determine which causes of death contribute the most to social inequalities in mortality in each age group in the whole population of Scania, Sweden. METHODS: Data from LOMAS (Longitudinal Multilevel Analysis in Skåne) were used to estimate 12-year follow-up mortality rates across levels of socioeconomic position (SEP) and workforce participation in 975,938 men and women aged 0 to 80 years, during 1991-2002. RESULTS: The results generally showed increasing absolute mortality differences between those holding manual and non-manual occupations with increasing age, while there were inverted u-shaped associations when using relative inequality measures. Cardiovascular diseases (CVD) contributed to 52% of the male socioeconomic difference in overall mortality, cancer to 18%, external causes to 4% and psychiatric disorders to 3%. The corresponding contributions in women were 55%, 21%, 2% and 3%. Additionally, those outside the workforce (i.e., students, housewives, disability pensioners, and the unemployed) showed a strongly increased risk of future mortality in all age groups compared to those inside the workforce. Even though coronary heart disease (CHD) played a major contributing role to the mortality differences seen, stroke and other types of cardiovascular diseases also made substantial contributions. Furthermore, while the most common types of cancers made substantial contributions to the socioeconomic mortality differences, in some age groups more than half of the differences in cancer mortality could be attributed to rarer cancers. CONCLUSION: CHD made a major contribution to the ...
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