| 1. |
- Espelt, A., et al.
(författare)
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Socioeconomic inequalities in diabetes mellitus across Europe at the beginning of the 21st century
- 2008
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Ingår i: Diabetologia. - : Springer Science and Business Media LLC. - 0012-186X .- 1432-0428. ; 51:11, s. 1971-1979
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Tidskriftsartikel (refereegranskat)abstract
- In Europe, educational attainment and diabetes are inversely related, in terms of both morbidity and mortality rates. This underlines the importance of targeting interventions towards low SEP groups. Access and use of healthcare services by people with diabetes also need to be improved.
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| 2. |
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| 3. |
- Idris, Berlian I., et al.
(författare)
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Higher smoking prevalence in urban compared to non-urban areas: Time trends in six, European countries
- 2007
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Ingår i: Health and Place. - : Elsevier BV. - 1873-2054 .- 1353-8292. ; 13:3, s. 702-712
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Tidskriftsartikel (refereegranskat)abstract
- We investigated differences in smoking prevalence between urban and non-urban area of residence in six Western European countries (Sweden, Finland, Denmark, Germany, Italy and Spain), and smoking prevalence trends over the period 1985-2000. In most countries, smoking prevalence was highest in urban areas, and increased with urbanization. Urban/non-urban inequalities were most pronounced among individuals with low education levels, and also among females. There were no significant differences in annual rate of change in smoking prevalence between non-urban and urban areas. (c) 2006 Elsevier Ltd. All rights reserved.
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| 4. |
- Leinsalu, Mall, et al.
(författare)
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Educational inequalities in mortality in four Eastern European countries : divergence in trends during the post-communist transition from 1990 to 2000
- 2009
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Ingår i: International Journal of Epidemiology. - : Oxford University Press (OUP). - 0300-5771 .- 1464-3685. ; 38, s. 512-525
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Post-communist transition has had a huge impact on mortality in Eastern Europe. We examined how educational inequalities in mortality changed between 1990 and 2000 in Estonia, Lithuania, Poland and Hungary.METHODS:Cross-sectional data for the years around 1990 and 2000 were used. Age-standardized mortality rates and mortality rate ratios (for total mortality only) were calculated for men and women aged 35-64 in three educational categories, for five broad cause-of-death groups and for five (seven among women) specific causes of death.RESULTS:Educational inequalities in mortality increased in all four countries but in two completely different ways. In Poland and Hungary, mortality rates decreased or remained the same in all educational groups. In Estonia and Lithuania, mortality rates decreased among the highly educated, but increased among those of low education. In Estonia and Lithuania, for men and women combined, external causes and circulatory diseases contributed most to the increasing educational gap in total mortality.CONCLUSIONS:Different trends were observed between the two former Soviet republics and the two Central Eastern European countries. This divergence can be related to differences in socioeconomic development during the 1990s and in particular, to the spread of poverty, deprivation and marginalization. Alcohol and psychosocial stress may also have been important mediating factors.
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| 5. |
- Leinsalu, Mall, et al.
(författare)
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Social determinants of ever initiating smoking differ from those of quitting : a cross-sectional study in Estonia.
- 2007
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Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 17:6, s. 572-578
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Tidskriftsartikel (refereegranskat)abstract
- While educational level was the strongest predictor of ever initiating regular smoking, smoking cessation was related more directly to aspects of social disadvantage originating in adult life. To be effective, tobacco control interventions should not only target lower educated, but also those in material disadvantage.
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| 6. |
- Mackenbach, Johan P, et al.
(författare)
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Socioeconomic inequalities in health in 22 European countries
- 2008
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Ingår i: New England Journal of Medicine. - 0028-4793 .- 1533-4406. ; 358:23, s. 2468-2481
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Tidskriftsartikel (refereegranskat)abstract
- We observed variation across Europe in the magnitude of inequalities in health associated with socioeconomic status. These inequalities might be reduced by improving educational opportunities, income distribution, health-related behavior, or access to health care.
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| 7. |
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| 8. |
- Menvielle, Gwenn, et al.
(författare)
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The role of smoking and diet in explaining educational inequalities in lung cancer incidence.
- 2009
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Ingår i: Journal of the National Cancer Institute. - : Oxford University Press (OUP). - 1460-2105 .- 0027-8874. ; 101:5, s. 321-330
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Studies in many countries have reported higher lung cancer incidence and mortality in individuals with lower socioeconomic status. METHODS: To investigate the role of smoking in these inequalities, we used data from 391,251 participants in the European Prospective Investigation into Cancer and Nutrition study, a cohort of individuals in 10 European countries. We collected information on smoking (history and quantity), fruit and vegetable consumption, and education through questionnaires at study entry and gathered data on lung cancer incidence for a mean of 8.4 years. Socioeconomic status was defined as the highest attained level of education, and participants were grouped by sex and region of residence (Northern Europe, Germany, or Southern Europe). Relative indices of inequality (RIIs) of lung cancer risk unadjusted and adjusted for smoking were estimated using Cox regression models. Additional analyses were performed by histological type. RESULTS: During the study period, 939 men and 692 women developed lung cancer. Inequalities in lung cancer risk (RII(men) = 3.62, 95% confidence interval [CI] = 2.77 to 4.73, 117 vs 52 per 100,000 person-years for lowest vs highest education level; RII(women) = 2.39, 95% CI = 1.77 to 3.21, 46 vs 25 per 100,000 person-years) decreased after adjustment for smoking but remained statistically significant (RII(men) = 2.29, 95% CI = 1.75 to 3.01; RII(women) = 1.59, 95% CI = 1.18 to 2.13). Large RIIs were observed among men and women in Northern European countries and among men in Germany, but inequalities in lung cancer risk were reverse (RIIs < 1) among women in Southern European countries. Inequalities differed by histological type. Adjustment for smoking reduced inequalities similarly for all histological types and among men and women in all regions. In all analysis, further adjustment for fruit and vegetable consumption did not change the estimates. CONCLUSION: Self-reported smoking consistently explains approximately 50% of the inequalities in lung cancer risk due to differences in education.
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| 9. |
- Schaap, M. M., et al.
(författare)
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Effect of nationwide tobacco control policies on smoking cessation in high and low educated groups in 18 European countries
- 2008
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Ingår i: Tobacco Control. - : BMJ. - 0964-4563 .- 1468-3318. ; 17:4, s. 248-255
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Tidskriftsartikel (refereegranskat)abstract
- Background: Recently a scale was introduced to quantify the implementation of tobacco control policies at country level. Our study used this scale to examine the potential impact of these policies on quit ratios in European countries. Special attention was given to smoking cessation among lower educational groups. Methods: Cross-sectional data were derived from national health surveys from 18 European countries. In the analyses we distinguished between country, sex, two age groups (25-39 and 40-59 years) and educational level. Age-standardised quit ratios were calculated as total former-smokers divided by total ever-smokers. In regression analyses we explored the correlation between national quit ratios and the national score on the Tobacco Control Scale (TCS). Results: Quit ratios were especially high (> 45%) in Sweden, England, The Netherlands, Belgium and France and relatively low (< 30%) in Lithuania and Latvia. Higher educated smokers were more likely to have quit smoking than lower educated smokers in all age-sex groups in all countries. National score on the tobacco control scale was positively associated with quit ratios in all age-sex groups. The association of quit ratios with score on TCS did not show consistent differences between high and low education. Of all tobacco control policies of which the TCS is constructed, price policies showed the strongest association with quit ratios, followed by an advertising ban. Conclusion: Countries with more developed tobacco control policies have higher quit ratios than countries with less developed tobacco control policies. High and low educated smokers benefit about equally from the nationwide tobacco control policies.
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| 10. |
- Schaap, Maartje M, et al.
(författare)
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Female ever-smoking, education, emancipation and economic development in 19 European countries
- 2009
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Ingår i: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 68:7, s. 1271-1278
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Tidskriftsartikel (refereegranskat)abstract
- Large differences in ever-smoking rates among women are found between countries and socio-economic groups. This study examined the socio-economic inequalities in female ever-smoking rates in 19 European countries, and explored the association between cross-national differences in these inequalities and economic development and women's emancipation. Data on smoking were derived from national health interview surveys from 19 European countries. For each country, age group (25-39, 40-59 and 60+ years), educational level (4 standard levels), and cumulative ever-smoking rates were calculated as the proportion of current and former smokers of the total survey population. A Relative Index of Inequality was estimated for women in the three age groups to measure the magnitude of educational differences. In regression analyses the association of ever-smoking rates of women age 25-39 years with the gross domestic product (GDP) and the Gender Empowerment Measure (GEM) was explored. Less educated women aged 25-39 years were more likely to have ever smoked than more educated women in all countries, except Portugal. In the age groups 40-59 years the educational pattern differed between countries. Women aged 60+ years who were less educated were less likely to have ever smoked in all countries, except Norway and England. The size of inequalities varied considerably between countries and reversed within three age groups. For women 25-39 years, the association of ever-smoking rates with GDP was positive, especially for more educated women. The association of ever-smoking rates with GEM was positive for less educated women, but negative for more educated women. The results are consistent with the idea that economic development and social-cultural processes related to gender empowerment have affected the diffusion of smoking in different ways for more and less educated women.
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