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| 2. |
- Long, Di, et al.
(författare)
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Smoking and inequalities in mortality in 11 European countries : a birth cohort analysis
- 2021
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Ingår i: Population Health Metrics. - : BioMed Central (BMC). - 1478-7954. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To study the trends of smoking-attributable mortality among the low and high educated in consecutive birth cohorts in 11 European countries.METHODS: Register-based mortality data were collected among adults aged 30 to 79 years in 11 European countries between 1971 and 2012. Smoking-attributable deaths were estimated indirectly from lung cancer mortality rates using the Preston-Glei-Wilmoth method. Rate ratios and rate differences among the low and high-educated were estimated and used to estimate the contribution of inequality in smoking-attributable mortality to inequality in total mortality.RESULTS: In most countries, smoking-attributable mortality decreased in consecutive birth cohorts born between 1906 and 1961 among low- and high-educated men and high-educated women, but not among low-educated women among whom it increased. Relative educational inequalities in smoking-attributable mortality increased among both men and women with no signs of turning points. Absolute inequalities were stable among men but slightly increased among women. The contribution of inequality in smoking-attributable mortality to inequality in total mortality decreased in consecutive generations among men but increased among women.CONCLUSIONS: Smoking might become less important as a driver of inequalities in total mortality among men in the future. However, among women, smoking threatens to further widen inequalities in total mortality.
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| 3. |
- Lundberg, Olle, 1958-
(författare)
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Den ojämlika ohälsan : om klass- och könsskillnader i sjuklighet
- 1990
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This study addresses the question of inequalities in health between social classes and betweenmen and women. The purpose of the study is threefold, namely 1) to map class and sex differencesin illnes in Sweden, 2) to seek an explanation for class differences in health and 3) toseek an explanation for sex differences in health. The analyses are mainly performed on datafrom the Swedish Level of Living surveys which were conducted in 1968, 1974 and 1981.The second chapter has a descriptive focus, where the purpose is to show the magnitude ofclass and sex differences in illness and mortality in Sweden. The conclusion of the literaturereviews and the analyses undertaken is that social class and sex differences in illness persist inSweden, although class inequalities in health tend to be smaller than in other comparablecountries.In Chapter Three the question of health-related social mobility as an explanation for classdifferences in illness is analysed. Two types of health-related social mobility are distinguished,namely direct and indirect health-related mobility. The analyses show that although healthrelatedsocial mobility may contribute to class differences in health, other factors are moreimportant for the persisting class gradient in illness.In Chapter Four, several possible causal factors behind class inequalities in health are considered.These are economic problems during upbringing, economic resources, physical workingconditions, psychological working conditions, weak social network, and health-relatedbehaviours (alcohol and tobacco consumption). The analyses, conducted on both cross-sectionaland longitudinal data, point to physical working conditions as a major cause behindclass differences in physical illness, and as a not unimportant factor behind class differencesin mental health problems as well. Conditions during childhood and alcohol and tobacco consumptionalso appear to be of some importance for the production of class inequalities inhealth. On the other hand, class differences in psychological working conditions, measuredas work stress and job decision latitude, seem to diminish rather than increase class differencesin illness, especially mental illness.Chapter Five addresses the question of possible mechanisms behind the female excess ofillness. Two factors are drawn from the present theoretical debate to be tested, namely responsibilityfor everyday household work and societal integration. Although fairly brief andexploratory in nature, the analyses quite clearly point to the combination of household workand social integration as a crucial factor for the understanding of sex differences in health.Finally, the implications for public health policy of the results produced in the study arediscussed. It is argued that class differences in health provide a major potential for publichealth improvement, by reducing health risks for those in the least healthy categories. Furthermore,the analyses undertaken in this study quite clearly point to class differences in physicalworking conditions as the most important factor to change if one wants to achieve a reductionof illness risks for those most exposed. The importance of class differences in childhoodconditions are also highlighted as a crucial factor for subsequent health inequalities.
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| 5. |
- Lundberg, Olle, 1958-
(författare)
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Små välfärdsresurser ger sämre hälsa
- 2011
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Ingår i: Tvärsnitt. - Stockholm : Vetenskapsrådet. - 0348-7997. ; :3-4, s. 52-55
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 7. |
- van Raalte, Alyson, et al.
(författare)
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More variation in lifespan in lower educated groups: evidence from 10 European countries
- 2011
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Ingår i: International Journal of Epidemiology. - : Oxford University Press (OUP). - 0300-5771 .- 1464-3685. ; 40, s. 1703-1714
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Tidskriftsartikel (refereegranskat)abstract
- Background Whereas it is well established that people with a lower socio-economic position have a shorter average lifespan, it is less clear what the variability surrounding these averages is. We set out to examine whether lower educated groups face greater variation in lifespans in addition to having a shorter life expectancy, in order to identify entry points for policies to reduce the impact of socio-economic position on mortality. Methods We used harmonized, census-based mortality data from 10 European countries to construct life tables by sex and educational level (low, medium, high). Variation in lifespan was measured by the standard deviation conditional upon survival to age 35 years. We also decomposed differences between educational groups in lifespan variation by age and cause of death. Results Lifespan variation was higher among the lower educated in every country, but more so among men and in Eastern Europe. Although there was an inverse relationship between average life expectancy and its standard deviation, the first did not completely predict the latter. Greater lifespan variation in lower educated groups was largely driven by conditions causing death at younger ages, such as injuries and neoplasms. Conclusions Lower educated individuals not only have shorter life expectancies, but also face greater uncertainty about the age at which they will die. More priority should be given to efforts to reduce the risk of an early death among the lower educated, e.g. by strengthening protective policies within and outside the health-care system.
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| 9. |
- Östergren, Olof, et al.
(författare)
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Adjustment method to ensure comparability between populations reporting mortality data in different formats in the EURO-GBD-SE project : Working document
- 2011
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: In some of the longitudinal data sets within the EURO-GBD-SE project, information on age isonly available at baseline, all person years and deaths are attributed to the baseline age; thismeans that information about age at death is unavailable. This will cause a bias whencomparing mortality between data sets in which age at death is reported and data sets in whichage at baseline is reported. Mortality estimates in populations that have age at baseline will behigher than the estimations obtained where age at death is known; since people are notallowed to move into the next age category as they grow older, the population will, in reality,be older in the former case. The data sets that are formatted with age at baseline only areBrussels, Denmark, Finland, Norway, Sweden and Switzerland.To make results comparable, we developed an adjustment procedure that corrects for this bias.This procedure should be applied to the datasets formatted with the age at baseline and is represented in this document.
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| 10. |
- Östergren, Olof, 1984-, et al.
(författare)
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Disruption and selection : the income gradient in mortality among natives and migrants in Sweden
- 2023
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Ingår i: European Journal of Public Health. - 1101-1262 .- 1464-360X. ; 33:3, s. 372-377
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Tidskriftsartikel (refereegranskat)abstract
- Background The income gradient in mortality is generated through an interplay between socio-economic processes and health over the life course. International migration entails the displacement of an individual from one context to another and may disrupt these processes. Furthermore, migrants are a selected group that may adopt distinct strategies and face discrimination in the labour market. These factors may have implications for the income gradient in mortality. We investigate whether the income gradient in mortality differs by migrant status and by individual-level factors surrounding the migration event.MethodsWe use administrative register data comprising the total resident population in Sweden aged between 30 and 79 in 2015 (n = 5.7 million) and follow them for mortality during 2015-17. We estimate the income gradient in mortality by migrant status, region of origin, age at migration and country of education using locally estimated scatterplot smoothing and Poisson regression.ResultsThe income gradient in mortality is less steep among migrants compared with natives. This pattern is driven by lower mortality among migrants at lower levels of income. The gradient is less steep among distant migrants than among close migrants, migrants that arrived as adults compared with children and migrants that received their education in Sweden as opposed to abroad.ConclusionsOur results are consistent with the notion that income inequalities in mortality are generated through life-course processes that may be disrupted by migration. Data restrictions prevent us from disentangling life-course disruption from selection into migration, discrimination and labour market strategies.
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