Pekkanen J, Uutela A, Valkonen T, Vartiainen E, Tuomilehto J, Puska P
Department of Environmental Epidemiology, National Public Health Institute, Kuopio, Finland.
J Epidemiol Community Health. 1995 Apr;49(2):144-9. doi: 10.1136/jech.49.2.144.
To compare differences in coronary heart disease (CHD) risk factor levels between educational groups in the 1970s and 1980s in eastern Finland.
Independent, cross sectional population surveys were undertaken in 1972, 1977, 1982, and 1987 of randomly selected men and women aged 30-59 living in two provinces in eastern Finland. Altogether 20,096 subjects participated. The lowest observed level of participation in either sex or province in any year was 77%. Serum cholesterol values and blood pressure measurements, body mass index, smoking, and the level of education were determined in each survey using comparable methodology.
More poorly educated men and women had higher levels of all risk factors at the end of the study period (1987). There was no change between 1972 and 1987 in differences between educational groups in mean serum cholesterol values and the diastolic blood pressure level in either sex, and in smoking in men. In women, the proportion of smokers was highest in the better educated in the 1970s but lowest in this group in the 1980s (interaction between year of examination and educational level p < 0.01). Differences between educational groups in mean body mass index increased with time in both men (p < 0.001) and women (p = 0.06).
Relative differences between socioeconomic groups in CHD mortality have increased in Finland in the 1970s and 1980s. Present results from eastern Finland show no reduction in differences between educational groups in risk factor levels, and even some evidence of increasing differences. Although a comparison between mortality trends and risk factor trends is problematic, trends in the risk factors analysed do not seem to be a major cause for the increasing differences in CHD mortality in Finland, at least in men. On the other hand, the risk factor trends analysed show no progress towards reducing inequalities in health, a major goal of public health policy.
比较芬兰东部20世纪70年代和80年代不同教育程度人群的冠心病（CHD）危险因素水平差异。
于1972年、1977年、1982年和1987年对芬兰东部两个省份随机抽取的年龄在30 - 59岁的男性和女性进行独立的横断面人群调查。共有20,096名受试者参与。在任何一年中，任一性别或省份观察到的最低参与率为77%。每次调查均采用可比方法测定血清胆固醇值、血压测量值、体重指数、吸烟情况以及教育程度。
在研究期末（1987年），受教育程度较低的男性和女性所有危险因素水平更高。1972年至1987年期间，不同教育程度人群在平均血清胆固醇值、男女舒张压水平以及男性吸烟率方面的差异没有变化。在女性中，20世纪70年代受教育程度较高者吸烟比例最高，但在80年代该组吸烟比例最低（检查年份与教育水平之间的交互作用p < 0.01）。不同教育程度人群在平均体重指数方面的差异在男性（p < 0.001）和女性（p = 0.06）中均随时间增加。
20世纪70年代和80年代，芬兰社会经济群体之间冠心病死亡率的相对差异有所增加。芬兰东部目前的结果显示，不同教育程度人群在危险因素水平上的差异没有缩小，甚至有一些差异增大的证据。尽管死亡率趋势与危险因素趋势之间的比较存在问题，但至少在男性中，所分析的危险因素趋势似乎不是芬兰冠心病死亡率差异增加的主要原因。另一方面，所分析的危险因素趋势在减少健康不平等方面没有取得进展，而这是公共卫生政策的一个主要目标。
