Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via Vanzetti 5, 20133, Milan, Italy.
Italian National Institute of Statistics, Rome, Italy.
Int J Public Health. 2018 Sep;63(7):865-874. doi: 10.1007/s00038-018-1149-8. Epub 2018 Jul 26.
Evaluating socio-economic inequality in cause-specific mortality among the working population requires large cohort studies. Through this census-based study, we aimed to quantify disparities in mortality across occupation-based social classes in Italy.
We conducted a historical cohort study on a sample of more than 16 million workers. We estimated the mortality rate ratios for each social class, considering upper non-manual workers as reference.
Non-skilled manual workers showed an increased mortality from upper aero-digestive tract, stomach and liver cancers, and from diseases of the circulatory system, transport accidents and suicides in both sexes, and from infectious diseases, diabetes, lung and bladder cancers only in men. Among women, an excess mortality emerged for cervical cancer, whereas mortality from breast and ovarian cancers was lower. When education was taken into account, the excess mortality decreased in men while was no longer significant in women.
There are remarkable disparities across occupation-based social classes in the Italian working population that favour the upper non-manual workers. Our data could be useful in planning policies for a more effective health and social security system.
评估职业相关死亡率的社会经济不平等需要进行大规模的队列研究。通过这项基于人口普查的研究，我们旨在量化意大利职业社会阶层之间的死亡率差异。
我们对超过 1600 万工人的样本进行了一项历史队列研究。我们以高级非体力劳动者为参照，估计了每个社会阶层的死亡率比值。
非熟练体力劳动者的上呼吸道、胃和肝癌以及循环系统疾病、交通意外和自杀的死亡率在两性中均升高，且男性还会出现传染病、糖尿病、肺癌和膀胱癌的死亡率升高。女性中宫颈癌的死亡率过高，而乳腺癌和卵巢癌的死亡率则较低。考虑到教育因素后，男性的超额死亡率降低，但女性的超额死亡率不再显著。
意大利劳动人口中，基于职业的社会阶层之间存在显著的死亡率差异，高级非体力劳动者的死亡率较低。我们的数据可用于制定更有效的健康和社会保障政策。
