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芬兰糖尿病患者死亡率的社会经济差异:五年随访

Socioeconomic differences in mortality among diabetic people in Finland: five year follow up.

作者信息

Koskinen S V, Martelin T P, Valkonen T

机构信息

Department of Sociology, University of Helsinki, Finland.

出版信息

BMJ. 1996 Oct 19;313(7063):975-8. doi: 10.1136/bmj.313.7063.975.

Abstract

OBJECTIVE

To compare socioeconomic differences in mortality (by cause of death) among diabetic people with those in the rest of the population.

DESIGN

Five year follow up of mortality in the population of Finland, comparing people with diabetes and those without diabetes.

SETTING

Finland.

SUBJECTS

All residents of Finland aged 30 to 74 included in the 1980 census. Subjects were classified as diabetic (230,000 person years) or other (12,400,000 person years) according to whether they were exempted from charges for medication for diabetes. During 1981-5 there were 114,058 deaths, of which 11,215 were in people with diabetes.

MAIN OUTCOME MEASURES

Age standardised mortality by sex, social class, and cause of death for the diabetic and non-diabetic populations.

RESULTS

No significant social class differences in mortality were found among women with diabetes. Among diabetic men there was a slight increasing trend in mortality from the upper while collar group to the unskilled blue collar workers but it was much less steep than that of non-diabetic men.

CONCLUSIONS

Among people with diabetes in Finland the quality of treatment and compliance with treatment probably do not vary by socioeconomic status. Health education for diabetic people seems to be effective in all socioeconomic strata; in people from the lower strata this leads to greater changes because their health behavior was originally less good.

摘要

目的

比较糖尿病患者与其他人群在死亡率(按死因)方面的社会经济差异。

设计

对芬兰人群进行为期五年的死亡率随访,比较糖尿病患者和非糖尿病患者。

地点

芬兰。

研究对象

1980年人口普查中纳入的所有30至74岁的芬兰居民。根据是否免除糖尿病药物费用,将研究对象分为糖尿病患者(230,000人年)和其他人群(12,400,000人年)。1981 - 1985年期间共有114,058人死亡,其中11,215人是糖尿病患者。

主要观察指标

糖尿病患者和非糖尿病患者按性别、社会阶层和死因划分的年龄标准化死亡率。

结果

糖尿病女性中未发现明显的社会阶层死亡率差异。在糖尿病男性中,从高级白领群体到非熟练蓝领工人,死亡率有轻微上升趋势,但比非糖尿病男性的上升趋势平缓得多。

结论

在芬兰的糖尿病患者中,治疗质量和治疗依从性可能不会因社会经济地位而有所不同。对糖尿病患者的健康教育似乎在所有社会经济阶层都有效;在较低阶层的人群中,这会带来更大的变化,因为他们原本的健康行为较差。

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