INSERM, U1018, CESP Centre for Research in Epidemiology and Population Health, Epidemiology of Occupational and Social Determinants of Health Team, Villejuif, France.
Eur J Epidemiol. 2011 Jan;26(1):1-12. doi: 10.1007/s10654-010-9506-9. Epub 2010 Sep 16.
The respective contribution of occupational and behavioural factors to social disparities in all-cause mortality has been studied very seldom. The objective of this study was to evaluate the role of occupational and behavioural factors in explaining social inequalities in premature and total mortality in the French working population. The study population consisted of a sample of 2,189 and 1,929 French working men and women, who responded to a self-administered questionnaire in mid-1996, and were followed up until the end of 2008. Mortality was derived from register-based information and linked to the baseline data. Socioeconomic status was measured using occupation. Occupational factors included biomechanical and physical exposures, temporary contract, psychological demands, and social support, and behavioural factors, smoking, alcohol abuse, and body mass index. Significant social differences were observed for premature and total mortality. Occupational factors reduced the hazard ratios of mortality for manual workers compared to managers/professionals by 72 and 41%, from 1.88 (95% CI: 1.17-3.01) to 1.25 (95% CI: 0.74-2.12) for premature mortality, and from 1.71 (95% CI: 1.18-2.47) to 1.42 (95% CI: 0.95-2.13) for total mortality. The biggest contributions were found for biomechanical and physical exposures, and job insecurity. The role of behavioural factors was very low. Occupational factors played a substantial role in explaining social disparities in mortality, especially for premature mortality and men. Improving working conditions amongst the lowest social groups may help to reduce social inequalities in mortality.
职业和行为因素对全因死亡率的社会差异的各自贡献很少被研究。本研究的目的是评估职业和行为因素在解释法国劳动人口中过早和总死亡率的社会不平等方面的作用。研究人群由 2189 名和 1929 名法国男女工人组成，他们在 1996 年年中回答了一份自我管理问卷，并在 2008 年底之前进行了跟踪。死亡率来源于基于登记的信息，并与基线数据相联系。社会经济地位通过职业来衡量。职业因素包括生物力学和物理暴露、临时合同、心理需求和社会支持，以及行为因素，如吸烟、酗酒和体重指数。过早和总死亡率都观察到了显著的社会差异。职业因素将体力劳动者与经理/专业人员的死亡率风险比降低了 72%和 41%，从过早死亡率的 1.88（95%CI：1.17-3.01）降至 1.25（95%CI：0.74-2.12），从总死亡率的 1.71（95%CI：1.18-2.47）降至 1.42（95%CI：0.95-2.13）。最大的贡献来自生物力学和物理暴露以及工作不安全感。行为因素的作用非常低。职业因素在解释死亡率的社会差异方面发挥了重要作用，尤其是对于过早死亡率和男性。改善社会地位最低的群体的工作条件可能有助于减少死亡率的社会不平等。
