Περίληψη:
Background: Socio-economic inequalities in mortality are observed at the
country level in both North America and Europe. The purpose of this work
is to investigate the contribution of specific risk factors to social
inequalities in cause-specific mortality using a large multi-country
cohort of Europeans.
Methods: A total of 3,456,689 person/years follow-up of the European
Prospective Investigation into Cancer and Nutrition (EPIC) was analysed.
Educational level of subjects coming from 9 European countries was
recorded as proxy for socioeconomic status (SES). Cox proportional
hazard model’s with a step-wise inclusion of explanatory variables were
used to explore the association between SES and mortality; a Relative
Index of Inequality (RII) was calculated as measure of relative
inequality.
Results: Total mortality among men with the highest education level is
reduced by 43% compared to men with the lowest (HR 0.57, 95% C.I.
0.52-0.61); among women by 29% (HR 0.71, 95% C.I. 0.64-0.78). The risk
reduction was attenuated by 7% in men and 3% in women by the
introduction of smoking and to a lesser extent (2% in men and 3% in
women) by introducing body mass index and additional explanatory
variables (alcohol consumption, leisure physical activity, fruit and
vegetable intake) (3% in men and 5% in women). Social inequalities
were highly statistically significant for all causes of death examined
in men. In women, social inequalities were less strong, but
statistically significant for all causes of death except for
cancer-related mortality and injuries.
Discussion: In this European study, substantial social inequalities in
mortality among European men and women which cannot be fully explained
away by accounting for known common risk factors for chronic diseases
are reported.
Συγγραφείς:
Gallo, Valentina
Mackenbach, Johan P.
Ezzati, Majid and
Menvielle, Gwenn
Kunst, Anton E.
Rohrmann, Sabine
Kaaks,
Rudolf
Teucher, Birgit
Boeing, Heiner
Bergmann, Manuela M.
and Tjonneland, Anne
Dalton, Susanne O.
Overvad, Kim and
Redondo, Maria-Luisa
Agudo, Antonio
Daponte, Antonio and
Arriola, Larraitz
Navarro, Carmen
Barricante Gurrea, Aurelio and
Khaw, Kay-Tee
Wareham, Nick
Key, Tim
Naska, Androniki and
Trichopoulou, Antonia
Trichopoulos, Dimitrios
Masala, Giovanna
and Panico, Salvatore
Contiero, Paolo
Tumino, Rosario and
Bueno-de-Mesquita, H. Bas
Siersema, Peter D.
Peeters, Petra P.
and Zackrisson, Sophia
Almquist, Martin
Eriksson, Sture and
Hallmans, Goran
Skeie, Guri
Braaten, Tonje
Lund, Eiliv and
Illner, Anne-Kathrin
Mouw, Traci
Riboli, Elio
Vineis, Paolo
