IJE Advance Access originally published online on February 28, 2005
International Journal of Epidemiology 2005 34(2):316-326; doi:10.1093/ije/dyh386
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Socioeconomic differences in the prevalence of common chronic diseases: an overview of eight European countries
1 Department of Public Health, Erasmus MC, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
2 Agencia de Salut Publica de Barcelona, Spain
3 Department of Epidemiology and Public Health, University College London, UK
4 Institut National d'Etudes Démographiques (Ined), Paris, France
5 Department of Public Health and Microbiology, University of Turin, Italy
6 Statistics Netherlands, The Netherlands
7 Department of Public Health, University of Helsinki, Finland
8 Scientific Institute of Public Health, Brussels, Belgium
9 National Institute of Public Health, Copenhagen, Denmark
10 Department of Preventive Medicine and Public Health, Universidad Complutense de Madrid, Spain
11 Servizio di Epidemiologia, Piemonte, Italy
* Corresponding author. Department of Public Health, Erasmus MC, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. E-mail: j.dalstra{at}erasmusmc.nl
Background Few studies have compared socioeconomic inequalities in the prevalence of both fatal and non-fatal diseases. This paper aims to give the first international overview for several common chronic diseases.
Methods Micro-level data were pooled from non-standardized national health surveys conducted in eight European countries in the 1990s. Surveys ranged in size from 3700 to 41 200 participants. The prevalence of 17 chronic disease groups were analysed in relation to education. Standardized prevalence rates and age-adjusted odds ratios (ORs) were calculated.
Results Most diseases showed higher prevalence among the lower education group. Stroke, diseases of the nervous system, diabetes, and arthritis displayed relatively large inequalities (OR > 1.50). No socioeconomic differences were evident for cancer, kidney diseases, and skin diseases. Allergy was more common in the higher education group. Relative socioeconomic differences were often smaller among the 60–79 age group as compared with the 25–59 age group. Cancer was more prevalent among the lower educated in the 25–59 age group, but among the higher educated in the 60–79 age group. For diabetes, hypertension, and heart disease, socioeconomic differences were larger among women as compared with men. Inequalities in heart disease were larger in northern European countries as compared with southern European countries.
Conclusion There are large variations between chronic diseases in the size and pattern of socioeconomic differences in their prevalence. The large inequalities that are found for some specific fatal diseases (e.g. stroke) and non-fatal diseases (e.g. arthritis) require special attention in equity-oriented research and policies.
Keywords socioeconomic differences, chronic diseases, working-age population, elderly, Europe
Accepted 28 October 2004
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