Bosma H, Appels A, Sturmans F, Grabauskas V, Gostautas A
Department of Medical Psychology, University of Limburg, Maastricht, The Netherlands.
Int J Epidemiol. 1995 Feb;24(1):119-26. doi: 10.1093/ije/24.1.119.
A 9.5-year follow-up of the Kaunas-Rotterdam Intervention Study (KRIS) provided the opportunity of investigating whether the educational level of wives was associated with their husbands' risk of mortality and coronary heart disease (CHD), independently of the educational level of the husbands themselves.
The data represent populations consisting of 2452 Lithuanian men and 3365 Dutch men. These men were extensively screened for cardiovascular risk factors in the period 1972-1974. During the follow-up 303 Kaunasians and 350 Rotterdammers died. We used the Cox proportional hazards and the logistic regression models to analyse the data.
We found that men whose spouses had little education apparently had an increased risk of all-cause mortality, even when their own educational level was taken into account. The relative risks (RR) were 1.57 in Kaunas and 2.15 in Rotterdam. The results for fatal and non-fatal myocardial infarctions were compatible with this finding, especially in Rotterdam. The prevalence of smoking was higher among men whose wives had primary schooling only. Nonetheless, adjusting the effect of the wife's educational level on her husband's mortality risk for all coronary risk factors in the husband only partially explained the association.
The spouse's educational level appears to have independent effects on a man's risk of mortality in both eastern and western European communities. The results strongly suggest that including characteristics of the socioeconomic status of an individual's spouse would improve studies of socioeconomic differences in health.
考纳斯 - 鹿特丹干预研究（KRIS）的9.5年随访提供了一个机会，可用于调查妻子的教育水平是否与其丈夫的死亡风险和冠心病（CHD）风险相关，且独立于丈夫自身的教育水平。
数据来自由2452名立陶宛男性和3365名荷兰男性组成的人群。这些男性在1972 - 1974年期间接受了广泛的心血管危险因素筛查。在随访期间，303名考纳斯人和350名鹿特丹人死亡。我们使用Cox比例风险模型和逻辑回归模型来分析数据。
我们发现，配偶受教育程度低的男性显然全因死亡风险增加，即使考虑到他们自己的教育水平也是如此。考纳斯的相对风险（RR）为1.57，鹿特丹为2.15。致命和非致命心肌梗死的结果与此发现相符，尤其是在鹿特丹。妻子仅接受过小学教育的男性中吸烟率更高。然而，仅调整丈夫所有冠心病危险因素后妻子教育水平对其丈夫死亡风险的影响，只能部分解释这种关联。
在东欧和西欧社区，配偶的教育水平似乎对男性的死亡风险有独立影响。结果强烈表明，纳入个人配偶的社会经济地位特征将改善对健康方面社会经济差异的研究。
