Regional and social class variation in the relative risk of death from amenable causes in the city of Helsinki, 1980-1986.

BACKGROUND

Relative risk of death from causes amenable to health services' intervention was studied in a case-control design to ascertain regional and social class differences.

METHODS

The data were 2091 deaths from amenable causes and 8364 randomly drawn living controls in 1980-1986 in the seven health districts in Helsinki, Finland. Logistic regression was used to adjust relative risk estimates for age, sex and marital status.

RESULTS

Adjustments decreased the risk ratios. Compared with the Southern District, the Middle District had significantly higher adjusted relative risk (RR = 1.4; 95% confidence interval [CI]: 1.1-1.7). People with no address had even higher relative risk (RR = 3.1; 95% CI: 2.3-4.2). Compared with social group I, increased relative risks were found in social group II (RR = 1.3; 95% CI: 1.1-1.6), group III (RR = 2.0; 95% CI: 1.6-2.4), group IV (RR = 1.9; 95% CI: 1.5-2.5) and group VI (RR = 8.5; 95% CI: 6.9-10.6). Males had higher relative risk than females (RR = 2.4; 95% CI: 2.1-2.8). Of the dead with no address, 29% were pensioners and 41% had been registered unemployed or occupation was unknown; 48% were single and 17% divorced.

CONCLUSIONS

Our results suggest that regional inequalities in health care between various districts in Helsinki are small. However, to a large extent two overlapping groups, social group VI and people with no address, seem to delineate a deprived group likely to need special help from health care.