Kopp Maria, Skrabski Arpád, Szántó Zsuzsa, Siegrist Johannes
Institute of Behavioural Sciences, Semmelweis University, H-1089 Budapest, Nagyvárad tér 4, Hungary.
J Epidemiol Community Health. 2006 Sep;60(9):782-8. doi: 10.1136/jech.2005.042960.
The life expectancy gap between Central-Eastern European (CEE) countries, including Hungary, and Western Europe (WE) is mainly attributable to excess cardiovascular (CV) mortality in midlife. This study explores the contribution of socioeconomic, work related, psychosocial, and behavioural variables to explaining variations of middle aged male and female CV mortality across 150 sub-regions in Hungary.
Cross sectional, ecological analyses.
150 sub-regions of Hungary.
12 643 people were interviewed in Hungarostudy 2002 survey, representing the Hungarian population according to sex, age, and sub-regions. Independent variables were income, education, control in work, job insecurity, weekend working hours, social support, depression, hostility, anomie, smoking, body mass index, and alcohol misuse.
Gender specific standardised premature (45-64 years) total CV, ischaemic heart disease, and cerebrovascular mortality rates in 150 sub-regions of Hungary.
Low education and income were the most important determinants of mid-aged CV mortality differences across sub-regions. High weekend workload, low social support at work, and low control at work account for a large part of variation in male premature CV mortality rates, whereas job insecurity, high weekend workload, and low control at work contribute most noticeably to variations in premature CV mortality rates among women. Low social support from friends, depression, anomie, hostility, alcohol misuse and cigarette smoking can also explain a considerable part of variations of premature CV mortality differences.
Variations in middle aged CV mortality rates in a rapidly changing society in CEE are largely accounted for by distinct unfavourable working and other psychosocial stress conditions.
包括匈牙利在内的中东欧（CEE）国家与西欧（WE）之间的预期寿命差距主要归因于中年时期心血管（CV）死亡率过高。本研究探讨社会经济、工作相关、心理社会和行为变量对解释匈牙利150个次区域中年男性和女性CV死亡率差异的贡献。
横断面生态分析。
匈牙利的150个次区域。
在2002年匈牙利研究调查中，对12643人进行了访谈，这些人根据性别、年龄和次区域代表匈牙利人口。自变量包括收入、教育程度、工作中的控制权、工作不安全感、周末工作时长、社会支持、抑郁、敌意、失范、吸烟、体重指数和酒精滥用。
匈牙利150个次区域按性别划分的标准化过早（45 - 64岁）总CV、缺血性心脏病和脑血管死亡率。
低教育程度和低收入是各次区域中年CV死亡率差异的最重要决定因素。高周末工作量、工作中社会支持低以及工作控制权低在男性过早CV死亡率差异中占很大一部分，而工作不安全感、高周末工作量和工作控制权低对女性过早CV死亡率差异的影响最为显著。来自朋友的社会支持低、抑郁、失范、敌意、酒精滥用和吸烟也可以解释过早CV死亡率差异的相当一部分。
中东欧快速变化社会中中年CV死亡率的差异很大程度上是由明显不利的工作和其他心理社会压力状况造成的。
