| 1. |
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| 2. |
- Aström, Daniel Oudin, et al.
(författare)
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Acute Fatal Effects of Short-Lasting Extreme Temperatures in Stockholm, Sweden : Evidence Across a Century of Change.
- 2013
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Ingår i: Epidemiology. - : Lippincott Williams & Wilkins. - 1044-3983 .- 1531-5487. ; 24:6, s. 820-829
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Climate change is projected to increase the frequency of extreme weather events. Short-term effects of extreme hot and cold weather and their effects on mortality have been thoroughly documented, as have epidemiologic and demographic changes throughout the 20th century. We investigated whether sensitivity to episodes of extreme heat and cold has changed in Stockholm, Sweden, from the beginning of the 20th century until the present.METHODS: We collected daily mortality and temperature data for the period 1901-2009 for present-day Stockholm County, Sweden. Heat extremes were defined as days for which the 2-day moving average of mean temperature was above the 98th percentile; cold extremes were defined as days for which the 26-day moving average was below the 2nd percentile. The relationship between extreme hot/cold temperatures and all-cause mortality, stratified by decade, sex, and age, was investigated through time series modeling, adjusting for time trends.RESULTS: Total daily mortality was higher during heat extremes in all decades, with a declining trend over time in the relative risk associated with heat extremes, leveling off during the last three decades. The relative risk of mortality was higher during cold extremes for the entire period, with a more dispersed pattern across decades. Unlike for heat extremes, there was no decline in the mortality with cold extremes over time.CONCLUSIONS: Although the relative risk of mortality during extreme temperature events appears to have fallen, such events still pose a threat to public health.
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| 3. |
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| 4. |
- Bergman, Maria, 1981-
(författare)
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Constructing communities : The establishment and demographic development of sawmill communities in the Sundsvall district, 1850-1890
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation studies the establishment and demographic development of the sawmill communities that emerged in the Sundsvall district during the latter half of the 19th century. The intention is to highlight the importance of the sawmill communities and their resident populations by discussing community construction from a demographic perspective as well as socially and symbolically. Based on church registers, this is a longitudinal study that includes information from 31 individual sawmill communities. This study has shown that the establishment and demographic development of the sawmill communities was not an instant process that necessarily followed the construction of the sawmill industries. The prerequisites of the geographical locations and year of establishment influenced population development, but the speed and size of the settlements were individual to each mill site. More prosperous times for the industry during the 1870s resulted in that migration increased consequently leading to quickly populated communities and larger registered core populations in residence. Migration to the sawmill communities from within the parishes was infrequent and the geographical backgrounds revealed that an extremely small proportion of the populations had been born within the district, implying a migratory hesitation among locally born. The sawmill populations were male-dominated due to the large groups of temporary workers inhabiting the communities, although, adult males barely made up one-third of the registered populations. The largest demographic group was children aged 0-14 years. The strong presence of children and high proportions of married individuals suggests that the sawmill communities were family oriented communities, more so than non-sawmill areas. Long-time settled families had usually formed kinship networks with other residents. This dissertation concludes that while time was important for the development of the sawmill communities, so were the registered populations residing in these communities. Residency would have been key in claiming belonging to the sawmill communities and to be considered as a real sawmill worker. Residency, family and kin therefore contributed to the construction of community structures, geographically, socially and symbolically.
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| 5. |
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| 6. |
- Broström, Göran, et al.
(författare)
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Social class and sex-specific adult mortality during 200 years in Sweden
- 2019
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Konferensbidrag (refereegranskat)abstract
- Recent regional studies on adult mortality and socio-economic status inSweden are merged and also completed with analyses from country-widecensuses in strategic time periods, with the purpose to find out whetherthe locally drawn conclusions about a changing social gradient in mortalitystill holds.The answer is firmly positive: While the upper classes have definiteadvantage in modern time (after, say, the 1960s), the reverse situationholds during the nineteenth and early twentieth century for men. Women, onthe other hand, seem to follow the expected pattern of a positive socialgradient through the last 200 years.
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| 7. |
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| 8. |
- Brändström, Anders, et al.
(författare)
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Clustering across generations : a comparative analysis of infant mortality in 19th century Sweden
- 2007
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Ingår i: ESSHC Conference in Lisbon, 26 February-1 March, 2008.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Many studies in the past have emphasized the positive correlation between infant mortality and fertility, but how this operates remain unclear. In this paper, we investigate these interdependent processes using data from the Demographic Data base at Ume{\aa} University. More specifically, we have data from regions in the northern part of Sweden, starting in the fifteenth century and ending around the year 1900. In an earlier paper, we have studied the intergenerational aspects of infant mortality and in this paper we incorporate fertility. We investigate the interaction between the two processes and how patterns are tranferred from generation to generation.
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| 9. |
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| 10. |
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| 11. |
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| 12. |
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| 13. |
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| 14. |
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| 15. |
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| 16. |
- Brändström, Anders, et al.
(författare)
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Introduction
- 2002
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Ingår i: Hygiea Internationalis. - : Linkoping University Electronic Press. - 1403-8668 .- 1404-4013. ; 3:1, s. 7-11
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 17. |
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| 18. |
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| 19. |
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| 20. |
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| 21. |
- Bygren, Lars Olov, et al.
(författare)
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Change in food availability during pregnancy : Is it related to adult sudden death from cerebro- and cardiovascular disease in offspring?
- 2000
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Ingår i: American Journal of Human Biology. - : John Wiley & Sons. - 1042-0533 .- 1520-6300. ; 12:4, s. 447-453
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Tidskriftsartikel (refereegranskat)abstract
- Maternal access to food during pregnancy affects birth weight and other characteristics of offspring. It has been suggested that fluctuations in food availability during infancy, ranging from plentiful to starvation, may influence cerebro-cardiovascular risk factors for the offspring during adult life. This study was designed to test the correlation between food availability changes during life before birth and adult sudden death from disease. This was a follow-up study of ancient cohorts in the parish of Skelleftea, Sweden, comprising 7,572 individuals born between 1805 and 1849 and still alive at age 40. Food availability variations in the parish during their prenatal life were ascertained from historical sources, the main outcome measures being overall mortality and mortality from sudden death in the age range 40-70 years. The risk of sudden death was almost doubled for those whose mothers were struck by a poor harvest during the early stages of pregnancy, but who experienced a good harvest toward the end. Yet almost the same over-risk was evident for the converse case: plentiful food supply in early pregnancy followed by a poor harvest toward the end. A stable maternal access to food during pregnancy is important for the offspring's risk of sudden death from cerebro- and cardiovascular disease as an adult.
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| 22. |
- Bygren, Lars Olov, 1936-, et al.
(författare)
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Change in paternal grandmothers' early food supply influenced cardiovascular mortality of the female grandchildren
- 2014
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Ingår i: BMC Genetics. - : BioMed Central. - 1471-2156. ; 15, s. 12-
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Tidskriftsartikel (refereegranskat)abstract
- Background: This study investigated whether large fluctuations in food availability during grandparents' early development influenced grandchildren's cardiovascular mortality. We reported earlier that changes in availability of food - from good to poor or from poor to good - during intrauterine development was followed by a double risk of sudden death as an adult, and that mortality rate can be associated with ancestors' childhood availability of food. We have now studied transgenerational responses (TGR) to sharp differences of harvest between two consecutive years' for ancestors of 317 people in Overkalix, Sweden. Results: The confidence intervals were very wide but we found a striking TGR. There was no response in cardiovascular mortality in the grandchild from sharp changes of early exposure, experienced by three of the four grandparents (maternal grandparents and paternal grandfathers). If, however, the paternal grandmother up to puberty lived through a sharp change in food supply from one year to next, her sons' daughters had an excess risk for cardiovascular mortality (HR 2.69, 95% confidence interval 1.05-6.92). Selection or learning and imitation are unlikely explanations. X-linked epigenetic inheritance via spermatozoa seemed to be plausible, with the transmission, limited to being through the father, possibly explained by the sex differences in meiosis. Conclusion: The shock of change in food availability seems to give specific transgenerational responses.
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| 23. |
- Bygren, Lars Olov, 1936-, et al.
(författare)
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Epigenetics or ephemeral genetics? : Reply to Senn
- 2006
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Ingår i: European Journal of Human Genetics. - : Nature publishing group. - 1018-4813 .- 1476-5438.
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Annan publikation (övrigt vetenskapligt/konstnärligt)
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| 24. |
- Bygren, Lars Olov, 1936-, et al.
(författare)
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Longevity determined by parental ancestors' nutrition during their slow growth period
- 2001
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Ingår i: Acta Biotheoretica. - : Springer. - 0001-5342 .- 1572-8358. ; 49:1, s. 53-59
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Tidskriftsartikel (refereegranskat)abstract
- Social circumstances often impinge on later generations in a socio-economic manner, giving children an uneven start in life. Overfeeding and overeating might not be an exception. The pathways might be complex but one direct mechanism could be genomic imprinting and loss of imprinting. An intergenerational "feedforward" control loop has been proposed, that links grandparental nutrition with the grandchild's growth. The mechanism has been speculated to be a specific response, e.g. to their nutritional state, directly modifying the setting of the gametic imprint on one or more genes. This study raises the question: Can overnutrition during a child's slow growth period trigger such direct mechanisms and partly determine mortality? Data were collected by following-up a cohort born in 1905 in Överkalix parish, northernmost Sweden. The probands were characterised by their parents' or grandparents' access to food during their own slow growth period. Availability of food in the area was defined by referring to historical data on harvests and food prices, records of local community meetings and general historical facts.If there was a surfeit of food in the environment when the paternal grandfather was a 9–12 year old boy a shortening of the proband survival could be demonstrated. The influence of parents', maternal grandparents' and paternal grandmothers' access to food during their slow growth period was discounted in a multivariable analysis. The results are indicative of very early programming mechanisms in human adaptation to the social environment.
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| 25. |
- Diamant, Ulla-Britt, et al.
(författare)
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LQTS founder population in Northern Sweden – the natural history of a potentially fatal inherited cardiac disorder
- 2021
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Ingår i: Biodemography and Social Biology. - : Routledge. - 1948-5565 .- 1948-5573. ; 66:3-4, s. 191-207
-
Tidskriftsartikel (refereegranskat)abstract
- Long QT Syndrome (LQTS) is an autosomal dominant inherited cardiac disorder associated with life-threatening arrhythmias. In northern Sweden, a LQTS founder mutation (p.Y111C, KCNQ1 gene) was verified by genetic haplotype analysis and genealogical studies, and a common ancestor couple was identified. Clinical studies of this population revealed an apparent mild phenotype. However, due to early commencement of prophylactic treatment, the natural history of this disorder cannot be properly assessed based only on clinical data. By using the family tree mortality ratio method (FTMR), we assessed the natural history of the untreated LQTS founder population. The principle of FTMR is to compare the age-specific mortality rates in a historic population harboring an inherited disorder with the corresponding mortality rates in an unaffected control population.Initially, we used the general Swedish population during the same period for comparison and observed an apparent increased longevity in the p.Y111C study population. However, when using a control population born in the same area, we observed no differences regarding overall mortality. Moreover, patterns suggesting age- and sex-stratified excess mortality, in accordance with previous LQTS studies, were evident.This study shows the importance of being aware of historical demographic patterns to avoid misinterpreting when comparing historical data.
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| 26. |
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| 27. |
- Edvinsson, Sören, 1953-, et al.
(författare)
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A database for the future major contributions from 47 years of database development and research at the demographic data base
- 2020
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Ingår i: Historical Life Course Studies. - : International Institute of Social History. - 2352-6343. ; 9, s. 173-196
-
Tidskriftsartikel (refereegranskat)abstract
- The Demographic Data Base (DDB) at the Centre for Demographic and Ageing Research (CEDAR) at Umeå University has since the 1970s been building longitudinal population databases and disseminating data for research. The databases were built to serve as national research infrastructures, useful for addressing an indefinite number of research questions within a broad range of scientific fields, and open to all academic researchers who wanted to use the data. A countless number of customised datasets have been prepared and distributed to researchers in Sweden and abroad and to date, the research has resulted in more than a thousand published scientific reports, books, and articles within a broad range of academic fields. While there has long been a clear predominance of research within the humanities and social sciences, it has always been used for research in other fields as well, for example medicine. In this article, we first give a brief presentation of the DDB and its history, characteristics, and development from the 1970s to the present. It includes an overview of the research based on the DDB databases, with a focus on the databases POPUM and POPLINK with individual-level data. A number of major traits of the research from 1973 to now have been outlined, showing the breadth of the research and highlighting some major contributions, with a focus on work that would have been very difficult to perform without data from the DDB.
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| 28. |
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| 29. |
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| 30. |
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| 31. |
- Edvinsson, Sören, 1953-, et al.
(författare)
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Clustering of deaths in families : Infant and child mortality in historical perspective
- 2012
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Ingår i: Biodemography and Social Biology. - : Taylor & Francis Group. - 1948-5565 .- 1948-5573. ; 58:2, s. 75-86
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Tidskriftsartikel (refereegranskat)abstract
- This introduction surveys the field of family clustering of deaths and discusses the contributionsin this special issue. The main focus is on mortality in historical contexts.Clustering of deaths in families has been found both in historical and contemporarypopulations, and we argue that the ‘family approach’ to infant and child mortality yieldsimportant and interesting insights for our understanding of different mortality patternsand the mortality transition. The articles in this issue, representing different but complementaryapproaches to the problem of death clustering, demonstrate that we shouldbe aware of the strong family effects on child health, but also that we need to developadequate methods for the analysis of this complex phenomenon. Here we discuss severalexplanations for death clustering, such as different biodemographic factors andthose focusing on socioeconomic and cultural variables. We also discuss some of themethodological challenges in studying family clustering, and emphasize the need forcomparison and the adoption of common measures.
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| 32. |
- Edvinsson, Sören, 1953-
(författare)
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Den osunda staden : sociala skillnader i dödlighet i 1800-talets Sundsvall
- 1992
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This study deals with the topic of social class and mortality. In particular, the analyses are concentrated on the question of how social differences developed in an era which was characterised by industrialisation, urbanisation and sanitary improvements. This work also discusses how the problems of social class and health were dealt with in the nineteenth Century. The development of medicai care and public health are especially studied. The development of mortality in different social classes is analysed on micro level in the town of Sundsvall during the 19th century, for which the parish registers for the period 1803-1894 have been transferred on to data. This town became the centre of an expansive saw mill area from the middle of the Century.In contrast to the view of contemporary witnesses, inequality seems to have been fairly small in some age groups, but the pattems diverged between them. Mortality among adults was largely dependent on cultural variables such as life style and attitudes, and social differences played a minor role. Men had much higher mortality than women. The development does not seem to have been primarily affected by industrialisation, urbanisation or sanitary improvements. For children 1-14 years old, on the other hand, conditions created by industrialisation and urbanisation seem to have been of the utmost importance. Child mortality increased from 1860, affecting first of all working class children. Overcrowding increased the spread of infectious diseases. Sanitary improvements may have had an effect on the mortality level from around 1880, but more definitely in the 1890's. The same is also the case regarding infant mortality. They may have had some impact on the initial decline in infant mortality, but the connection appears to be stronger in the 1890's. The social inequality in infant mortality was insignificant until late 19th centuiy, but increased at that time. Among infants, feeding practises were also of importance.
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| 33. |
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| 34. |
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| 35. |
- Edvinsson, Sören, et al.
(författare)
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Do unequal societies cause death among the elderly? : a study of the health effects of inequality in Swedish municipalities, 2006
- 2013
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Ingår i: Global Health Action. - : Taylor & Francis. - 1654-9716 .- 1654-9880. ; 6:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: A lively public and academic debate has highlighted the potential health risk of living in regions and nations characterized by inequality. However, previous research provides an ambiguous picture, with positive association mainly having been found on higher geographical levels. One explanation for this could be that the effect of living in more heterogeneous social settings differs between levels of aggregation. Methods: We examine the association between income inequality (using the Gini coefficient) and all-cause mortality in Swedish municipalities in the age group 65-74. A multi-level analysis is applied and we control for e.g. individual income and average income level in the unicipality. The analyses are based on individual register data on all residents born between 1932 and 1941, and outcomes are measured for the year 2006.Results: Lower individual income as well as lower average income level in the municipality of residence increased mortality significantly. We found an association between income inequality and mortality with excessive deaths in unequal municipalities even after controlling for mean income level and personal income. The results from the analysis of individual data differed substantially from analyses using aggregate data.Conclusions: Income inequality has a significant association with mortality in the age groups 65 to 75 at municipality level. The association is small compared to many other variables, but it is not negligible. Even in a comparatively equal society like Sweden, we need to consider possible effects of income inequality on mortality at the local level.
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| 36. |
- Edvinsson, Sören, 1953-, et al.
(författare)
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Do unequal societies cause death and disease? : A study of the health effects on elderly of inequality in Swedish municipalities, 2006
- 2011
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- A lively public and academic debate has highlighted the potential health risk of living in regions and nations characterized by inequality (Wilkinson and Pickett 2007; 2009). It is argued that inequality may add to increasing health differentials over the life course. However, previous research provides so far an ambiguous picture. One explanation could be that the effect of living in more heterogeneous social settings may differ between levels of aggregation. A hypothesis is that homogeneity is positive on the national or regional level, while on a lower level of aggregation living in homogeneous settings could be detrimental for health, at least in poor neighborhoods. In this paper we present the preliminary results of our examination on how residence in unequal versus homogeneous areas is associated with health outcome of elderly people in Sweden. These first results are based on municipality level data on individuals born between 1932 and 1941 and the outcome is measured for the year 2006. Furthermore, we analyze the effect on health of income inequality (measured by Gini-coefficient) as compared to the effect of individual income and the average income level in the area. We analysed the associations both with individual-level and multi-level analysis. Our main finding is that inequality has an independent effect on mortality in the way that unequal municipalities have excessive deaths even after controlling for mean income level and personal income. This result was found not only in the individual-level analysis but also in the multilevel analysis.
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| 37. |
- Edvinsson, Sören, 1953-
(författare)
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Dödlighet och familjebildning under 1600- och 1700-talet
- 2007
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Ingår i: Historisk Tidskrift. - : Svenska Historiska Föreningen. - 0345-469X .- 2002-4827. ; 127:1, s. 78-86
-
Recension (övrigt vetenskapligt/konstnärligt)abstract
- Under några decennier har den historie-demografiska forskningen varit livaktig såväl i Sverige som i andra länder. För en tid var forskningsinriktningen representerad vid de flesta svenska lärosäten. Under senare år har emellertid mycket av forskningen koncentrerats till några få ställen i Sverige, framför allt Lund och Umeå. Det är därför glädjande att det nu kommit en avhandling från Göteborg med denna inriktning, nämligen Daniel Larssons Den dolda transitionen. Han tillhör en grupp som inriktar sig på befolkningshistoriska studier vid Göteborgs historiska institution. Det är också glädjande att Larssons avhandling handlar om äldre demografisk historia. Visst har en hel del gjorts, bland annat av Eli F. Heckscher och Nils Friberg, men det som karakteriserat den senare svenska historie-demografiska forskningen har med några undantag varit koncentrationen på tidsperioden efter 1750. En förklaring torde vara att källäget för den perioden har varit så pass mycket bättre. Tabellverket och kyrkobokföringen gör det svenska befolkningshistoriska källmaterialet världsunikt, och informationen i kyrkböckerna har varit lämplig att överföra till databaser. Svensk forskning har, helt naturligt, skördat frukterna där vinsterna varit mest givande. Nackdelen är att man varit alltför ängslig att gå till äldre material som krävt betydligt mer arbete och lösningar av många metodologiska problem. Svenska forskare har inte i tillräcklig utsträckning utnyttjat de källor för äldre tider som ändå finns. Vi har också endast i begränsad omfattning utvecklat metoder för att analysera dessa data. I andra länder har man av nödtvång drivits till att utveckla sina analysmetoder för att över huvud taget kunna säga något om befolkningen i äldre tid.
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| 38. |
- Edvinsson, Sören, 1953-
(författare)
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Fattiga stadsflyttares livsöden
- 2010
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Ingår i: Historisk Tidskrift. - 0345-469X .- 2002-4827. ; 130:4, s. 779-785
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Recension (övrigt vetenskapligt/konstnärligt)
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| 39. |
- Edvinsson, Sören, 1953-, et al.
(författare)
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Folkhälsans historia från 1870 till nutid
- 1997
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Ingår i: Sundsvalls historia del 2. - Sundsvall : Stadshistoriska Kommittén. - 9188186075
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 40. |
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| 41. |
- Edvinsson, Sören, 1953-, et al.
(författare)
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Folkhälsans utveckling - tiden före 1870
- 1996
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Ingår i: Sundsvalls historia del 1. - Sundsvall : Stadshistoriska kommittén. - 9188186075
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 42. |
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| 43. |
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| 44. |
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| 45. |
- Edvinsson, Sören, 1953-, et al.
(författare)
-
Income inequality in Swedish municipalities 1986-2013 : Development and regional patterns
- 2021
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- In the present report, we investigate the patterns and trends of inequality in disposable income in the working-age population in Swedish municipalities 1986-2013. This period coincided with when Sweden changed from very lowlevels of inequality to one with substantially increasing inequality. Incomes has increased in all parts of Sweden, but differences in incomes between municipalities have widened. Asa result, large parts of Sweden have become poorer in a relative, although not in a nominative sense. At the same time, income inequality has increased substantially within as well as between municipalities. Present-day Swedes live in much more unequal environments, both at the national level and in the municipalities. The large city areas, or at least part of them, have had a much more advantageous economic development, but they also became more unequal. We see a division between parts of Sweden; there are clear differentiation tendencies between urban and rural parts, centre and periphery. Another finding is that the relation between mean income and income inequality has changed from the 1980s to the present. This association was negative a couple of decades ago, meaning that inequality was somewhat higher in poorer municipalities. From the 1990s onwards, the association is instead positive – affluent municipalities are more unequal.
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| 46. |
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| 47. |
- Edvinsson, Sören, 1953-, et al.
(författare)
-
Introduction
- 2002
-
Ingår i: Hygiea Internationalis. - Linköping : Linköping University Electronic Press. - 1403-8668 .- 1404-4013. ; 3:1, s. 7-11
-
Tidskriftsartikel (refereegranskat)
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| 48. |
- Edvinsson, Sören, 1953-, et al.
(författare)
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Introduction: major databases with historical longitudinal population data : development, impact and results
- 2023
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Ingår i: Historical Life Course Studies. - : International Institute of Social History. - 2352-6343. ; 13:4, s. 186-190
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Over the last 60 years several major historical databases with reconstructed life courses of large populations spanning decades have been launched. The development of these databases is indicative of considerable investments that have greatly expanded the possibilities for new research within the fields of history, demography, sociology, as well as other disciplines. In this volume spanning seven articles, eight databases are included that have had a wide impact on research in various disciplines. Each database had its own unique genesis that is well described in the articles assembled in this volume. They inform readers about how these databases have changed the course of research in historical demography and related disciplines, how settled findings were challenged or confirmed, and how innovative investigations were launched and implemented. In the end we explore how research with this kind of databases will develop in future.
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| 49. |
- Edvinsson, Sören, 1953-, et al.
(författare)
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Is high social class always beneficial for survival? : Northern Sweden 1801–2013
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Focusing on two regions in northern Sweden 1801–2013, we challenge common notions of the assumed advantage in survival of belonging to a high social class. The issue is analysed according to gender and age group (adults and elderly) and in relation to the developmentof economic inequality. The results show that high social class is not always favourable for survival. Men in the elite category had higher mortality compared to others during a large part of the studied period; a male mortality class reversal appears at a surprisingly late date, while the social gradient among women conforms to the expected pattern. Wesuggest that health-related behaviour is decisive not only in later but earlier phases of the mortality transition as well. The results implicate that the association between social class and health is more complex than is assumed in many of the dominant theories in demography and epidemiology.
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| 50. |
- Edvinsson, Sören, 1953-, et al.
(författare)
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Is high social class always beneficial for survival? : a study of northern Sweden 1801-2013
- 2020
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Focusing on two regions in northern Sweden 1801–2013, we challenge common notions of the assumed advantage in survival of belonging to a high social class. The issue is analysed according to gender and age group (adults and elderly) and in relation to the development of economic inequality. The results show that high social class is not always favourable for survival. Men in the elite category, particularly in working age, had higher mortality compared to others during a large part of the studied period; a male mortality class reversal appears at a surprisingly late date, while the social gradient among women conforms to the expected pattern. We suggest that health-related behaviour is decisive not only in later but earlier phases of the mortality transition as well. The results implicate that the association between social class and health is more complex than is assumed in many of the dominant theories in demography and epidemiology.
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