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  • 1.
    Carlson, Per
    Södertörn University, School of Sociology and Contemporary History, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Relatively poor, absolutely ill?: A study of regional income inequality in Russia and its possible health consequences2005In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 59, no 5, p. 389-394Article in journal (Refereed)
    Abstract [en]

    Study objective: To investigate whether the income distribution in a Russian region has a "contextual" effect on individuals' self rated health, and whether the regional income distributions are related to regional health differences. Methods: The Russia longitudinal monitoring survey (RLMS) is a survey (n = 7696) that is representative of the Russian population. With multilevel regressions both individual as well as contextual effects on self rated health were estimated. Main results: The effect of income inequality is not negative on men's self rated health as long as the level of inequality is not very great. When inequality levels are high, however, there is a tendency for men's health to be negatively affected. Regional health differences among men are in part explained by regional income differences. On the other hand, women do not seem to be affected in the same way, and individual characteristics like age and educational level seem to be more important. Conclusions: It seems that a rise in income inequality has no negative effect on men's self rated health as long as the level of inequality is not very great. On the other hand, when inequality levels are higher a rise tends to affect men's health negatively. A curvilinear relation between self rated health and income distribution is an interesting hypothesis. It could help to explain the confusing results that arise when you look at countries with a high degree of income inequality (USA) and those with lower income inequality (for example, Japan and New Zealand).

  • 2.
    Carlson, Per
    Stockholms universitet.
    Risk behaviours and self-rated health in Russia 19982001In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 55, no 11, p. 806-817Article in journal (Refereed)
  • 3. Geyer, Siegfried
    et al.
    Hemström, Örjan
    Peter, Richard
    Vågerö, Denny
    Stockholms universitet.
    Education, income, and occupational class cannot be used interchangeably in social epidemiology: Empirical evidence against a common practice2006In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 60, p. 804-810Article in journal (Refereed)
    Abstract [en]

    Study objective: Education, income, and occupational class are often used interchangeably in studies showing social inequalities in health. This procedure implies that all three characteristics measure the same underlying phenomena. This paper questions this practice. The study looked for any independent effects of education, income, and occupational class on four health outcomes: diabetes prevalence, myocardial infarction incidence and mortality, and finally all cause mortality in populations from Sweden and Germany.Design: Sweden: follow up of myocardial infarction mortality and all cause mortality in the entire population, based on census linkage to the Cause of Death Registry. Germany: follow up of myocardial infarction morbidity and all cause mortality in statutory health insurance data, plus analysis of prevalence data on diabetes. Multiple regression analyses were performed to calculate the effects of education, income, and occupational class before and after mutual adjustments.Setting and participants: Sweden (all residents aged 25-64) and Germany (Mettman district, Nordrhein-Westfalen, all insured persons aged 25-64).Main results: Correlations between education, income, and occupational class were low to moderate. Which of these yielded the strongest effects on health depended on type of health outcome in question. For diabetes, education was the strongest predictor and for all cause mortality it was income. Myocardial infarction morbidity and mortality showed a more mixed picture. In mutually adjusted analyses each social dimension had an independent effect on each health outcome in both countries.Conclusions: Education, income, and occupational class cannot be used interchangeably as indicators of a hypothetical latent social dimension. Although correlated, they measure different phenomena and tap into different causal mechanisms.

  • 4.
    Hu, Yannan
    et al.
    Erasmus University Medical Centre, Rotterdam, The Netherlands.
    van Lenthe, Frank J
    Erasmus University Medical Centre, Rotterdam, The Netherlands .
    Borsboom, Gerard J
    Erasmus University Medical Centre, Rotterdam, The Netherlands .
    Looman, Caspar W N
    Erasmus University Medical Centre, Rotterdam, The Netherlands .
    Bopp, Matthias
    University of Zurich, Zurich, Switzerland .
    Burström, Bo
    Karolinska Institutet.
    Dzúrová, Dagmar
    Charles University in Prague, Prague, Czech Republic .
    Ekholm, Ola
    University of Southern Denmark, Copenhagen, Denmark .
    Klumbiene, Jurate
    Lithuanian University of Health Sciences, Kaunas, Lithuania .
    Lahelma, Eero
    University of Helsinki, Helsinki, Finland.
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute for Health Development, Tallinn, Estonia .
    Regidor, Enrique
    Universidad Complutense de Madrid, Madrid, Spain .
    Santana, Paula
    Universidade de Coimbra, Coimbra, Portugal.
    de Gelder, Rianne
    Erasmus University Medical Centre, Rotterdam, The Netherlands .
    Mackenbach, Johan P
    Erasmus University Medical Centre, Rotterdam, The Netherlands .
    Trends in socioeconomic inequalities in self-assessed health in 17 European countries between 1990 and 20102016In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 70, no 7, p. 644-652Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Between the 1990s and 2000s, relative inequalities in all-cause mortality increased, whereas absolute inequalities decreased in many European countries. Whether similar trends can be observed for inequalities in other health outcomes is unknown. This paper aims to provide a comprehensive overview of trends in socioeconomic inequalities in self-assessed health (SAH) in Europe between 1990 and 2010.

    METHODS: Data were obtained from nationally representative surveys from 17 European countries for the various years between 1990 and 2010. The age-standardised prevalence of less-than-good SAH was analysed by education and occupation among men and women aged 30-79 years. Socioeconomic inequalities were measured by means of absolute rate differences and relative rate ratios. Meta-analysis with random-effects models was used to examine the trends of inequalities.

    RESULTS: We observed declining trends in the prevalence of less-than-good SAH in many countries, particularly in Southern and Eastern Europe and the Baltic states. In all countries, less-than-good SAH was more prevalent in lower educational and manual groups. For all countries together, absolute inequalities in SAH were mostly constant, whereas relative inequalities increased. Almost no country consistently experienced a significant decline in either absolute or relative inequalities.

    CONCLUSIONS: Trends in inequalities in SAH in Europe were generally less favourable than those found for inequalities in mortality, and there was generally no correspondence between the two when we compared the trends within countries. In order to develop policies or interventions that effectively reduce inequalities in SAH, a better understanding of the causes of these inequalities is needed.

  • 5.
    Leinsalu, Mall
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute for Health Development, Tallinn, Estonia.
    Reile, Rainer
    National Institute for Health Development, Tallinn, Estonia.
    Stickley, Andrew
    Södertörn University, School of Culture and Education. National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
    Economic fluctuations and long-term trends in depression: a repeated cross-sectional study in Estonia 2004-20162019In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 73, no 11, p. 1026-1032Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In the 2000s, the Baltic countries experienced unprecedented credit-driven economic growth that was followed by a deep recession. This study examined the impact of profound macroeconomic changes on population mental health in Estonia in 2004-2016.

    METHODS: Data on 17 794 individuals in the 20-64 age group were obtained from seven nationally representative cross-sectional surveys. The prevalence of past 30-day depression was calculated for men and women further stratified by sociodemographic characteristics. Multivariable regression analysis was used to assess whether these characteristics were associated with the yearly variation in depression.

    RESULTS: In 2006, the adjusted prevalence ratio for depression was 0.77 (95% CI 0.64 to 0.93) for men and 0.85 (95% CI 0.74 to 0.97) for women as compared with 2004; in 2010, the prevalence ratio as compared with 2008 for both men and women was 1.22 (95% CIs 1.04 to 1.43 and 1.09 to 1.37, respectively). Among men, the increase in the prevalence of depression in 2008-2010 was statistically significant for 35-64 year olds, ethnic Estonians, those who were married, mid-educated or were employed, whereas among women, a significant increase was observed in 50-64 year olds, Estonians and non-Estonians, those who were not-married, were highly educated or mid-educated, in the mid-income group or were employed.

    CONCLUSIONS: Population mental health is responsive to macroeconomic changes. In less wealthy high-income countries, the greater impact of recession on depression among advantaged groups may relate to a higher debt burden coupled with job insecurity.

  • 6.
    Leinsalu, Mall
    et al.
    Södertörn University, School of Sociology and Contemporary History, Sociology.
    Vågerö, Denny
    Södertörn University, Department of Society and History, SCOHOST (Stockholm Centre on Health of Societies in Transition). Södertörn University, Department of Society and History, Sociology.
    Kunst, Anton E
    Increasing ethnic differences in mortality in Estonia after the collapse of the Soviet Union2004In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 58, no 7, p. 583-589Article in journal (Refereed)
    Abstract [en]

    Political and economic upheaval, increasing poverty, and alcohol consumption can be considered the main underlying causes of the widening ethnic mortality gap.

  • 7. Mackenbach, Johan P
    et al.
    Kulhánová, Ivana
    Menvielle, Gwenn
    Bopp, Matthias
    Borrell, Carme
    Costa, Giuseppe
    Deboosere, Patrick
    Esnaola, Santiago
    Kalediene, Ramune
    Kovacs, Katalin
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute for Health Development, Tallinn, Estonia .
    Martikainen, Pekka
    Regidor, Enrique
    Rodriguez-Sanz, Maica
    Strand, Bjørn Heine
    Hoffmann, Rasmus
    Eikemo, Terje A
    Ostergren, Olof
    Lundberg, Olle
    Trends in inequalities in premature mortality: a study of 3.2 million deaths in 13 European countries.2015In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 69, p. 207-217Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Over the last decades of the 20th century, a widening of the gap in death rates between upper and lower socioeconomic groups has been reported for many European countries. For most countries, it is unknown whether this widening has continued into the first decade of the 21st century.

    METHODS: We collected and harmonised data on mortality by educational level among men and women aged 30-74 years in all countries with available data: Finland, Sweden, Norway, Denmark, England and Wales, Belgium, France, Switzerland, Spain, Italy, Hungary, Lithuania and Estonia.

    RESULTS: Relative inequalities in premature mortality increased in most populations in the North, West and East of Europe, but not in the South. This was mostly due to smaller proportional reductions in mortality among the lower than the higher educated, but in the case of Lithuania and Estonia, mortality rose among the lower and declined among the higher educated. Mortality among the lower educated rose in many countries for conditions linked to smoking (lung cancer, women only) and excessive alcohol consumption (liver cirrhosis and external causes). In absolute terms, however, reductions in premature mortality were larger among the lower educated in many countries, mainly due to larger absolute reductions in mortality from cardiovascular disease and cancer (men only). Despite rising levels of education, population-attributable fractions of lower education for mortality rose in many countries.

    CONCLUSIONS: Relative inequalities in premature mortality have continued to rise in most European countries, and since the 1990s, the contrast between the South (with smaller inequalities) and the East (with larger inequalities) has become stronger. While the population impact of these inequalities has further increased, there are also some encouraging signs of larger absolute reductions in mortality among the lower educated in many countries. Reducing inequalities in mortality critically depends upon speeding up mortality declines among the lower educated, and countering mortality increases from conditions linked to smoking and excessive alcohol consumption such as lung cancer, liver cirrhosis and external causes.

  • 8.
    Reile, Rainer
    et al.
    University of Tartu, Tartu, Estonia .
    Helakorpi, Satu
    National Institute for Health and Welfare (THL), Helsinki, Finland .
    Klumbiene, Jurate
    Lithuanian University of Health Sciences, Kaunas, Lithuania .
    Tekkel, Mare
    National Institute for Health Development, Tallinn, Estonia .
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition). National Institute for Health Development, Tallinn, Estonia .
    The recent economic recession and self-rated health in Estonia, Lithuania and Finland: a comparative cross-sectional study in 2004-20102014In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 68, no 11, p. 1072-1079Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The late-2000s financial crisis had a severe impact on the national economies on a global scale. In Europe, the Baltic countries were among those most affected with more than a 20% decrease in per capita gross domestic product in 2008-2009. In this study, we explored the effects of economic recession on self-rated health in Estonia and Lithuania using Finland, a neighbouring Nordic welfare state, as a point of reference.

    METHODS: Nationally representative cross-sectional data for Estonia (n=10 966), Lithuania (n=7249) and Finland (n=11 602) for 2004-2010 were analysed for changes in age-standardised prevalence rates of less-than-good self-rated health and changes in health inequalities using logistic regression analysis.

    RESULTS: The prevalence of less-than-good self-rated health increased slightly (albeit not statistically significantly) in all countries during 2008-2010. This was in sharp contrast to the statistically significant decline in the prevalence of less-than-good health in 2004-2008 in Estonia and Lithuania. Health disparities were larger in Estonia and Lithuania when compared to Finland, but decreased in 2008-2010 (in men only). In Finland, both the prevalence of less-than-good health and health disparities remained fairly stable throughout the period.

    CONCLUSIONS: Despite the rapid economic downturn, the short-term health effects in Estonia and Lithuania did not differ from those in Finland, although the recession years marked the end of the previous positive trend in self-rated health. The reduction in health disparities during the recession indicates that different socioeconomic groups were affected disproportionately; however, the reasons for this require further research.

  • 9. Roberts, Bayard
    et al.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Balabanova, Dina
    Haerpfer, Christian
    McKee, Martin
    The persistence of irregular treatment of hypertension in the former Soviet Union2012In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 66, no 11, p. 1079-1082Article in journal (Refereed)
    Abstract [en]

    Background Hypertension is one of the leading causes of avoidable mortality in the former Soviet Union (fSU). In previous work, the authors described patterns of irregular hypertension treatment in eight countries of the fSU in 2001. This paper presents new data on changes in the use of hypertension treatment in the same countries. Methods Using household survey data from 18 420 (2001) and 17 914 (2010) respondents from Armenia, Azerbaijan (2010 only), Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine, the authors describe changes in rates of irregular treatment use (less than daily) between 2001 and 2010. Multivariate logistic regression was also used to analyse the characteristics associated with irregular treatment. Results Irregular treatment was extremely high at 74% in 2001 and only fell to 68% in 2010 (all countries combined). Irregular treatment remained particularly high in 2010 in Armenia (79%), Kazakhstan (73%) and Moldova (73%). Recurring characteristics associated with irregular treatment included gender (men), younger age, higher fitness levels, and consuming alcohol and tobacco. Conclusions Irregular hypertension treatment continues to be a major problem in the countries of the fSU and requires an urgent response.

  • 10. Roberts, Bayard
    et al.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Balabanova, Dina
    McKee, Martin
    Irregular treatment of hypertension in the former Soviet Union2012In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 66, no 6, p. 482-488Article in journal (Refereed)
    Abstract [en]

    Background The USSR failed to establish a modern pharmaceutical industry and lacked the capacity for reliable distribution of drugs. Patients were required to pay for outpatient drugs and the successor states have inherited this legacy, so that those requiring long-term treatment face considerable barriers in receiving it. It was hypothesised that citizens of former Soviet republics requiring treatment for hypertension may not be receiving regular treatment. Aims To describe the regularity of treatment among those diagnosed with hypertension and prescribed treatment in eight countries of the former Soviet Union, and explore which factors are associated with not taking medication regularly. Methods Using data from over 18 000 respondents from eight former Soviet countries, individuals who had been told that they had hypertension by a health professional and prescribed treatment were identified. By means of multivariate logistic analysis the characteristics of those taking treatment daily and less than daily were compared. Results Only 26% of those prescribed treatment took it daily. The probability of doing so varied among countries and was highest in Russia, Belarus and Georgia, and lowest in Armenia ( although Georgia's apparent advantage may reflect low rates of diagnosis). Women, older people, those living in urban areas, and nonsmokers and non-drinkers were more likely to take treatment daily. Conclusions A high proportion of those who have been identified by health professionals as requiring hypertension treatment are not taking it daily. These findings suggest that irregular hypertension treatment is a major problem in this region and will require an urgent response.

  • 11. Roberts, Bayard
    et al.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Petticrew, Mark
    McKee, Martin
    The influence of concern about crime on levels of psychological distress in the former Soviet Union2012In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 66, no 5, p. 433-439Article in journal (Refereed)
    Abstract [en]

    Background Previous studies suggest that the fear of crime is associated with worse mental health, with social capital potentially having a mediating influence. However, no studies could be identified on this issue in countries of the former Soviet Union, despite them experiencing increasing rates of crime and profound social change. The aim of this study is to explore the relationship between concern about crime and levels of psychological distress in eight countries of the former Soviet Union. Methods Cross-sectional surveys were conducted in eight former Soviet countries using a standardised questionnaire containing items on psychological distress and concern about five criminal activities. Regression analysis was used to investigate the association between concern about criminal activities and psychological distress. Separate regression models were run to explore the influence of social capital on this relationship. Results The first model (excluding social capital) produced significant positive coefficients of association for all five types of criminal activity with psychological distress, with a range from 0.39 (95% CI 0.24 to 0.54) for suffering abuse because of nationality to 0.56 (95% CI 0.42 to 0.70) for being sexually molested. The second model (including social capital) also showed significant associations for all five criminal activities, but coefficients were slightly smaller. Conclusion This study provides preliminary evidence of a relationship between fear of crime and psychological distress in the study countries, with possibly a small mediating influence of social capital. Further studies are required to explore the relationship between fear of crime, social capital and mental health in the region.

  • 12. Shkolnikov, Vladimir M.
    et al.
    Andreev, Evgueni M.
    Jasilionis, Domantas
    Leinsalu, Mall
    Södertörn University, School of Sociology and Contemporary History, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Antonova, Olga
    McKee, Martin
    The changing relationship between education and life expectancy in eastern Europe in the 1990s.2006In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 60, no 10, p. 875-881Article in journal (Refereed)
  • 13.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Pridemore, W. A.
    The effects of binge drinking and social capital on violent victimisation: findings from Moscow2010In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 64, no 10, p. 902-907Article in journal (Refereed)
    Abstract [en]

    Background Rates of violence in Russia are among the highest in the orld, and violent victimisation represents a major public health threat n the country. As yet, however, little research has been undertaken on hat factors are associated with non-lethal violent victimisation in his setting. This study used data from the Moscow Health Survey 2004 to xamine the effects of binge drinking and social capital on individuals' isk of non-fatal violent victimisation. ethods A stratified random sampling strategy was used across Moscow's 25 municipal districts to collect data from 1190 individuals aged 18+ ears. Respondents reported if they had been a victim of physical iolence in the previous 12 months. Data were also collected on binge rinking (defined for men as consuming >= 80 g of pure alcohol, and for omen >= 60 g of pure alcohol, at least once per month) and social apital (frequency of interaction with relatives, friends and cquaintances). esults Overall, 8.7% of the respondents had been a victim of violence n the past 12 months. Men who binge drink were more than twice as ikely to have been a victim of non-lethal violence (OR 2.19, CI 1.23 to .92), while greater levels of social capital acted as a protective actor against male victimisation (OR 0.82, CI 0.69 to 0.97). Neither inge drinking nor social capital was associated with violent ictimisation among women. onclusion Urgent public health measures are now needed to reduce xcessive alcohol consumption and detrimental drinking patterns to bring own the high levels of violent victimisation in Russia.

  • 14. Stirbu, Irina
    et al.
    Kunst, Anton E
    Bopp, Matthias
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Regidor, Enrique
    Esnaola, Santiago
    Costa, Giuseppe
    Martikainen, Pekka
    Borrell, Carme
    Deboosere, Patrik
    Kalediene, Ramune
    Rychtarikova, Jitka
    Artnik, Barbara
    Mackenbach, Johan P.
    Educational inequalities in avoidable mortality in Europe2010In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 64, no 10, p. 913-920Article in journal (Refereed)
    Abstract [en]

    Inequalities in avoidable mortality were present in all European countries, but were especially pronounced in CEE and Baltic countries. These educational inequalities point to an important role for healthcare services in reducing inequalities in health.

  • 15.
    Tanaka, Hirokazu
    et al.
    Erasmus University Medical Center, Rotterdam, The Netherlands / University of Tokyo, Tokyo, Japan.
    Nusselder, Wilma J
    Erasmus University Medical Center, Rotterdam, The Netherlands.
    Bopp, Matthias
    University of Zürich, Zürich, Switzerland.
    Brønnum-Hansen, Henrik
    University of Copenhagen, Copenhagen, Denmark.
    Kalediene, Ramune
    Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Lee, Jung Su
    University of Tokyo, Tokyo, Japan.
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute for Health Development, Tallinn, Estonia.
    Martikainen, Pekka
    University of Helsinki, Helsinki, Finland.
    Menvielle, Gwenn
    Sorbonne Universités, Paris, France.
    Kobayashi, Yasuki
    University of Tokyo, Tokyo, Japan.
    Mackenbach, Johan P
    Erasmus University Medical Center, Rotterdam, The Netherlands.
    Mortality inequalities by occupational class among men in Japan, South Korea and eight European countries: a national register-based study, 1990–20152019In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 73, no 8, p. 750-758Article in journal (Refereed)
    Abstract [en]

    Background: We compared mortality inequalities by occupational class in Japan and South Korea with those in European countries, in order to determine whether patterns are similar.

    Methods: National register-based data from Japan, South Korea and eight European countries (Finland, Denmark, England/Wales, France, Switzerland, Italy (Turin), Estonia, Lithuania) covering the period between 1990 and 2015 were collected and harmonised. We calculated age-standardised all-cause and cause-specific mortality among men aged 35–64 by occupational class and measured the magnitude of inequality with rate differences, rate ratios and the average inter-group difference.

    Results: Clear gradients in mortality were found in all European countries throughout the study period: manual workers had 1.6–2.5 times higher mortality than upper non-manual workers. However, in the most recent time-period, upper non-manual workers had higher mortality than manual workers in Japan and South Korea. This pattern emerged as a result of a rise in mortality among the upper non-manual group in Japan during the late 1990s, and in South Korea during the late 2000s, due to rising mortality from cancer and external causes (including suicide), in addition to strong mortality declines among lower non-manual and manual workers.

    Conclusion: Patterns of mortality by occupational class are remarkably different between European countries and Japan and South Korea. The recently observed patterns in the latter two countries may be related to a larger impact on the higher occupational classes of the economic crisis of the late 1990s and the late 2000s, respectively, and show that a high socioeconomic position does not guarantee better health.

  • 16.
    Vågerö, Denny
    Stockholm University.
    Where does new theory come from?2006In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 60, p. 573-574Article in journal (Refereed)
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