Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
Department of Public Health and Nursing, HUNT Research Centre, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Eur J Public Health. 2024 Jun 7;34(3):435-440. doi: 10.1093/eurpub/ckae019.
Socioeconomic inequalities constitute an important focus area for public health, and it has long been established that higher educational level and longer lifespan are correlated. Little is known about decennial time trends in poor self-rated health and mental distress.
This study linked decennial cross-sectional survey data on self-rated health and mental distress from the Trøndelag Health Study (HUNT) from 1984 to 2019 with educational registry data using personal identification numbers. Survey participation ranged from 50 807 to 77 212. Slope index of inequality (SII) and relative index of inequality (RII) were calculated using generalized linear models in Stata. Analyses were stratified by sex and age, using the age categories of 30-59 years and 60-80 years.
Absolute inequalities in self-rated health and mental distress between educational groups have stayed relatively stable throughout all rounds of HUNT. Relative inequalities in self-rated health and mental distress have generally increased, and both men and women with the lowest education level were more likely to experience poor self-rated health and mental distress relative to those with the highest education level. RII in self-rated health increased over time for both sexes and both age groups. RII for mental distress increased in both sexes and both age groups, except for men and women aged 60-80.
This study shows that relative inequalities in self-rated and mental health in the Norwegian population are still persistent and have increased. Further knowledge about groups with a disadvantageous health situation should have implications for health care resource allocation.
社会经济不平等是公共卫生的一个重要焦点领域，长期以来，人们已经认识到较高的教育水平与较长的寿命相关。关于自评健康和精神困扰的十年时间趋势，人们知之甚少。
本研究使用个人身份号码将来自特隆赫姆健康研究（HUNT）的 1984 年至 2019 年期间的自评健康和精神困扰的十年横断面调查数据与教育登记数据进行了链接。调查参与人数从 50807 人到 77212 人不等。使用 Stata 中的广义线性模型计算不平等斜率指数（SII）和相对不平等指数（RII）。分析按性别和年龄分层，使用 30-59 岁和 60-80 岁这两个年龄组。
教育群体之间自评健康和精神困扰的绝对不平等在整个 HUNT 期间相对稳定。自评健康和精神困扰的相对不平等总体上有所增加，与教育水平最高的人相比，教育水平最低的男性和女性更有可能经历自评健康和精神困扰较差。男女两性和两个年龄组的自评健康 RII 随时间增加。男女两性和两个年龄组的精神困扰 RII 均增加，但 60-80 岁的男性和女性除外。
本研究表明，挪威人口的自评和心理健康的相对不平等仍然持续存在，并有所增加。关于处于不利健康状况的群体的进一步知识应该对医疗保健资源分配产生影响。
