International Journal of Epidemiology, Vol 28, 640-644, Copyright © 1999 by International Epidemiological Association
F Tuchsen and LA Endahl
BACKGROUND: In the mid 1980s European governments committed themselves to
the WHO goal 'reduced inequality in health by year 2000' according to which
inequality in health should be reduced by 25% by the year 2000. The study
aim is to estimate the time trend in relative risk due to ischaemic heart
disease (IHD) morbidity in employment status groups in Denmark in the
period from 1981 to 1993 and to recommend a strategy to reduce inequality
in health. MATERIAL AND METHODS: The study dealt with change in relative
risk of IHD in main employment status AND groups as measured in three
successive cohorts. The cohorts were defined as all METHODS: gainfully
employed men in Denmark as of 1 January 1981, 1986 and 1991, respectively.
Information on employment was retrieved for the three previous years. The
cohorts were followed for first admissions with IHD as the principal cause
during 5, 5, and 3 years respectively. RESULTS: Managers and white collar
workers had an average or low and decreasing relative risk while male blue
collar workers had a high and increasing relative risk. Thus the social
inequality in IHD is rapidly increasing. Some occupational groups are known
to be at high risk. Some of these high-risk groups, such as bus drivers,
even have an increasing relative risk. CONCLUSIONS: The general health
education has been successful in the prevention of IHD in the high-status
groups but has failed to reduce the risk among blue collar workers.
Preventive measures against IHD should focus on occupational groups at
high, increasing risk and the measures should tailor to their 'subculture.'
ARTICLES
Increasing inequality in ischaemic heart disease morbidity among employed men in Denmark 1981-1993: the need for a new preventive policy
National Institute of Occupational Health, Copenhagen, Denmark. ft@ami.dk
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