Galobardes Bruna, Costanza Michael C, Bernstein Martine S, Delhumeau Cecile, Morabia Alfredo
Division of Clinical Epidemiology, Geneva University Hospitals, Switzerland.
Am J Public Health. 2003 Aug;93(8):1302-9. doi: 10.2105/ajph.93.8.1302.
We report on trends in risk factors for lifestyle-related diseases among socioeconomic position (SEP) groups.
We continuously surveyed the adult population of Geneva, Switzerland, for 8 years (1993-2000) with independent, cross-sectional surveys of representative samples (4207 men and 3987 women aged 35-74 years). Age-adjusted linear regression slopes estimated annual risk factor trends. Interaction terms were tested for trend differences between SEP groups.
Overall, low-SEP persons had the worst risk factor profiles. Eight-year trends indicate that (1) number of pack-years smoked decreased by half a pack-year among high-SEP female current smokers only; (2) obesity prevalence more than doubled from 5% to 11% among high-SEP men only; (3) systolic and diastolic blood pressures decreased similarly in all SEP groups; (4) unsaturated-to-saturated dietary fat ratio declined in the low-SEP group only; and (5) physical inactivity and current/former cigarette smoking prevalences remained unchanged in all SEP groups.
Smoking, obesity, high blood pressure, and physical inactivity are more prevalent among low-SEP persons. Most socioeconomic risk factor differences remained stable in the 1990s. Thus, social inequalities in chronic disease morbidity and mortality will persist in the next decades.
我们报告社会经济地位(SEP)群体中与生活方式相关疾病的风险因素趋势。
我们对瑞士日内瓦的成年人口进行了为期8年(1993 - 2000年)的连续调查,采用对代表性样本(4207名年龄在35 - 74岁之间的男性和3987名女性)进行独立横断面调查的方式。年龄调整后的线性回归斜率估计年度风险因素趋势。对交互项进行测试以检验SEP群体之间的趋势差异。
总体而言,低SEP人群的风险因素状况最差。八年的趋势表明:(1)仅在高SEP的当前吸烟女性中,吸烟包年数减少了半包年;(2)仅在高SEP男性中,肥胖患病率从5%增加了一倍多至11%;(3)所有SEP群体的收缩压和舒张压均有类似程度的下降;(4)仅在低SEP组中,不饱和与饱和膳食脂肪比率下降;(5)所有SEP群体中身体活动不足以及当前/曾经吸烟的患病率保持不变。
吸烟、肥胖、高血压和身体活动不足在低SEP人群中更为普遍。20世纪90年代,大多数社会经济风险因素差异保持稳定。因此,在未来几十年中,慢性病发病率和死亡率方面的社会不平等现象仍将持续。