Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary.
Int J Behav Med. 2011 Mar;18(1):22-34. doi: 10.1007/s12529-010-9126-5.
Gender differences in premature mortality rates and in the size of socioeconomic inequalities in mortality vary across countries.
We aimed to quantify the gender differences in the association between socioeconomic status (SES) and premature all-cause mortality and to analyse whether psychosocial factors might associate between SES and mortality among men and women separately in the middle-aged Hungarian population.
Men (n = 1130) and women (n = 1529), aged 40-69 years, participants in the Hungarian Epidemiological Panel (2002) were followed up for 3.5 years for total mortality. Cox proportional hazard models were used to evaluate the association between several socioeconomic measures and total death.
During the follow-up, 99 men (8.8%) and 53 women (3.5%) died. The age-adjusted hazard ratios and the Rothman's synergy indexes showed that each measure of socioeconomic position was more deleterious in men compared with women. When investigating potential explanatory factors for the SES-mortality association, we found that adjustment for severe depression resulted in the most pronounced reduction in the regression coefficients for the association between most socioeconomic factors and male premature death. There was no indication that depression would mediate between SES and mortality in women. Work stress factors, poor lifestyle and low social support also contributed to the explanation of the link between socioeconomic disadvantage and premature death in men.
Middle-aged Hungarian men seem to be considerably more vulnerable to the chronic stress of material disadvantage than women. This effect modification by gender might partly be explained by a stronger connection between low SES and depressive symptoms in men.
在不同国家，过早死亡率和社会经济地位（SES）与死亡率之间的差异存在性别差异。
我们旨在量化 SES 与过早全因死亡率之间的关联的性别差异，并分析在中年匈牙利人群中，心理社会因素是否可能分别在男性和女性中 SES 与死亡率之间存在关联。
年龄在 40-69 岁的男性（n=1130）和女性（n=1529）参与者参加了匈牙利流行病学小组（2002 年），随访时间为 3.5 年，以评估总死亡率。使用 Cox 比例风险模型评估了几种 SES 指标与总死亡之间的关联。
在随访期间，99 名男性（8.8%）和 53 名女性（3.5%）死亡。年龄调整后的危险比和 Rothman 的协同指数表明，与女性相比，SES 中的每一个指标在男性中都更为有害。在研究 SES 与死亡率关联的潜在解释因素时，我们发现，严重抑郁的调整导致与大多数 SES 因素与男性过早死亡之间关联的回归系数的显著降低。没有迹象表明抑郁会在女性中调节 SES 和死亡率之间的关系。工作压力因素、不良生活方式和低社会支持也有助于解释社会经济劣势与男性过早死亡之间的联系。
中年匈牙利男性似乎比女性更容易受到物质劣势的慢性压力的影响。这种性别对性别影响的修正可能部分是由于低 SES 与男性抑郁症状之间的联系更强。
