McNamara Courtney L, Balaj Mirza, Thomson Katie H, Eikemo Terje A, Solheim Erling F, Bambra Clare
Department of Sociology and Political Science, Norwegian University of Science and Technology, Trondheim, Norway.
Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, UK.
Eur J Public Health. 2017 Feb 1;27(suppl_1):22-26. doi: 10.1093/eurpub/ckw222.
A range of non-communicable diseases (NCDs) has been found to follow a social pattern whereby socioeconomic status predicts either a higher or lower risk of disease. Comprehensive evidence on the socioeconomic distribution of NCDs across Europe, however, has been limited.
Using cross-sectional 2014 European Social Survey data from 20 countries, this paper examines socioeconomic inequalities in 14 self-reported NCDs separately for women and men: heart/circulatory problems, high blood pressure, back pain, arm/hand pain, foot/leg pain, allergies, breathing problems, stomach/digestion problems, skin conditions, diabetes, severe headaches, cancer, obesity and depression. Using education to measure socioeconomic status, age-controlled adjusted risk ratios were calculated and separately compared a lower and medium education group with a high education group.
At the pooled European level, a social gradient in health was observed for 10 NCDs: depression, diabetes, obesity, heart/circulation problems, hand/arm pain, high blood pressure, breathing problems, severe headaches, foot/leg pain and cancer. An inverse social gradient was observed for allergies. Social gradients were observed among both genders, but a greater number of inequalities were observed among women. Country-specific analyses show that inequalities in NCDs are present everywhere across Europe and that inequalities exist to different extents for each of the conditions.
This study provides the most up-to-date overview of socioeconomic inequalities for a large number of NCDs across 20 European countries for both women and men. Future investigations should further consider the diseases, and their associated determinants, for which socioeconomic differences are the greatest.
一系列非传染性疾病呈现出一种社会模式,即社会经济地位预示着疾病风险的高低。然而,关于欧洲非传染性疾病社会经济分布的全面证据一直有限。
本文利用来自20个国家的2014年欧洲社会调查横断面数据,分别考察了14种自我报告的非传染性疾病在男性和女性中的社会经济不平等情况,这些疾病包括:心脏/循环系统问题、高血压、背痛、手臂/手部疼痛、足部/腿部疼痛、过敏、呼吸问题、胃部/消化问题、皮肤疾病、糖尿病、严重头痛、癌症、肥胖症和抑郁症。以教育程度衡量社会经济地位,计算年龄调整后的风险比,并分别将低教育程度组和中等教育程度组与高教育程度组进行比较。
在欧洲总体水平上,观察到10种非传染性疾病存在健康方面的社会梯度:抑郁症、糖尿病、肥胖症、心脏/循环系统问题、手部/手臂疼痛、高血压、呼吸问题、严重头痛、足部/腿部疼痛和癌症。观察到过敏存在相反的社会梯度。男女中均观察到社会梯度,但女性中观察到的不平等情况更多。国家层面的分析表明,非传染性疾病的不平等在欧洲各地都存在,而且每种疾病的不平等程度各不相同。
本研究提供了20个欧洲国家大量非传染性疾病在男女中的社会经济不平等的最新概况。未来的调查应进一步考虑社会经济差异最大的疾病及其相关决定因素。