Kulhánová Ivana, Hoffmann Rasmus, Eikemo Terje A, Menvielle Gwenn, Mackenbach Johan P
Department of Public Health, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands,
Int J Public Health. 2014 Oct;59(5):687-96. doi: 10.1007/s00038-014-0576-4. Epub 2014 Jun 27.
Using new facilities for linking large databases, we aimed to evaluate for the first time the magnitude of relative and absolute educational inequalities in mortality by sex and cause of death in the Netherlands.
We analyzed data from Dutch Labour Force Surveys (1998-2002) with mortality follow-up 1998-2007 among people aged 30-79 years. We calculated hazard ratios using Cox proportional hazards model, age-standardized mortality rates and partial life expectancy by education. We compared results for the Netherlands with those for other European countries.
The relative risk of dying was about two times higher among primary educated men and women as compared to their tertiary educated counterparts, leading to a gap in partial life expectancy of 3.4 years (men) and 2.4 years (women). Inequalities in mortality are similar to those in other countries in North-Western Europe, but inequalities in lung cancer mortality are substantially larger in the Netherlands, particularly among men.
The Netherlands has large inequalities in mortality, especially for smoking-related causes of death. These large inequalities require the urgent attention of policy makers.
利用连接大型数据库的新设施，我们旨在首次评估荷兰按性别和死因划分的死亡率方面相对和绝对教育不平等的程度。
我们分析了荷兰劳动力调查（1998 - 2002年）的数据，并对1998 - 2007年期间30 - 79岁人群进行了死亡率随访。我们使用Cox比例风险模型、年龄标准化死亡率和按教育程度划分的部分预期寿命来计算风险比。我们将荷兰的结果与其他欧洲国家的结果进行了比较。
与受过高等教育的男性和女性相比，受过初等教育的男性和女性死亡的相对风险高出约两倍，导致部分预期寿命差距为3.4年（男性）和2.4年（女性）。死亡率不平等与西北欧其他国家相似，但荷兰肺癌死亡率的不平等程度要大得多，尤其是在男性中。
荷兰在死亡率方面存在巨大不平等，特别是与吸烟相关的死因。这些巨大的不平等需要政策制定者的紧急关注。
