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Socio-demographic predictors of mortality inequality among Swedish men and women: a longitudinal study
Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.ORCID-id: 0000-0003-4030-0449
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
2014 (Engelska)Ingår i: 7th European Public Health Conference Mind the gap: Reducing inequalities in health and health care Glasgow, 19–22 November 2014, Oxford University Press, 2014, Vol. 24, s. 188-189Konferensbidrag, Publicerat paper (Refereegranskat)
Abstract [en]

Background: Despite increasing life expectancy in many countries, health and mortality inequality exist. This study aimed to assess overall and cardiovascular (CVD) mortality trends among Swedish men and women during 1992-2006, and their association with individual level socio-demographic determinants of mortality inequality.

Methods: Data were extracted from the Linnaeus Database which consists of register and survey data. A multilevel Poisson regression analysis was used to assess the number and mortality rate, as well as individual level determinants (fixed effects) of overall and CVD deaths for men and women at county level (n = 24) in each 5-year period during 1992-2006. We also assessed the random effect at county level.

Results: A total of 9,098,090 individuals accumulating 115,361,104 person years was included in this study. A significant reduction in overall and CVD mortality rates occurred among Swedish men and women during the study period 1992-2006, with persisting excess male: female mortality. Older age and pensioner, unmarried or widowed individuals, low and middle education levels and employed individuals with low income (the lowest income tertile) were consistently associated with higher mortality rates of overall and CVD mortality in men and women. Individuals with tertiary education level and being immigrant was protective factors for overall mortality, but less so for CVD mortality. The multilevel analysis revealed that about 85% and 80% of the variation of overall and CVD mortality at county level, respectively, could be explained by the individual socio-demographic variables.

Conclusions: Inequality in overall and CVD mortality still exists among Swedish men and women, and to some extend are influenced by county level determinants. Contextual epidemiology must therefore play a decisive role in understanding social disparities in overall and CVD mortality in Sweden.

Key messages:

  • Overall, individual factors played a more important part in understanding the differences of overall and CVD mortality than contextual factors within the same area in men and women in Swedish context.

  • Health policy actions aiming to reduce health inequality should be addressed not only focusing on individual characteristics but also on geographical factors.

Ort, förlag, år, upplaga, sidor
Oxford University Press, 2014. Vol. 24, s. 188-189
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
URN: urn:nbn:se:umu:diva-124731DOI: 10.1093/eurpub/cku163.087OAI: oai:DiVA.org:umu-124731DiVA, id: diva2:954594
Konferens
7th European Public Health Conference, Glasgow, November 19-22, 2014
Tillgänglig från: 2016-08-23 Skapad: 2016-08-23 Senast uppdaterad: 2019-06-19Bibliografiskt granskad

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Santosa, AilianaRocklöv, JoacimByass, Peter

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Santosa, AilianaRocklöv, JoacimByass, Peter
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Institutionen för epidemiologi och global hälsaEpidemiologi och global hälsa
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi

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