International Journal of Epidemiology 2002;31:614-621
© International Epidemiological Association 2002
Social Inequalities |
Socioeconomic inequalities in cardiovascular mortality and the role of work: a register study of Finnish men
a Department of Epidemiology and Biostatistics, Finnish Institute of Occupational Health.
b Rehabilitation Foundation.
Simo V Virtanen, Department of Epidemiology and Biostatistics, Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, FIN-00250 Helsinki, Finland. E-mail: Simo.Virtanen{at}occuphealth.fi
Background In Finland, socioeconomic inequalities in mortality have been well documented. However, the role of working conditions in the emergence of those inequalities has not been thoroughly examined.
Methods Data came from the Longitudinal Census file, which included censuses since 1970 (every 5 years). The cohort consisted of men who were in the same occupation in 1975 and 1980, and who were between 25 and 64 years old in 1980. Farm work, mining and military occupations were excluded. Cardiovascular mortality of this cohort was followed up 1981–1994 (5.4 million person-years). Information on marital status, education and income was updated in 1985 and 1990. Working conditions were evaluated at occupational level (job exposure matrix). Poisson regression analyses were conducted to estimate the impact of independent variables on mortality. Inequalities were assessed in relation to occupational class and occupational category.
Results According to the models, elimination of unfavourable working conditions would have reduced the number of all cardiovascular deaths by 8%, myocardial infarctions by 10%, and cerebrovascular deaths by 18%. The most influential job exposures appeared to be high workload, low control, noise, and shift work. Income had a strong effect on mortality.
Conclusions Working conditions explained a relatively small portion of socioeconomic inequalities in mortality. Inequalities associated with occupational category and class were more attributable to varying levels of education and income.
Keywords Cardiovascular diseases, mortality, socioeconomic factors, occupational exposure, Finland, men
Accepted 30 November 2001
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