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Material, psychosocial, behavioural and biomedical factors in the explanation of socio-economic inequalities in mortality : evidence from the HUNT study.

Skalická, V. and Lenthe, F. and Bambra, C. and Krokstad, S. and Mackenbach, J. (2009) 'Material, psychosocial, behavioural and biomedical factors in the explanation of socio-economic inequalities in mortality : evidence from the HUNT study.', International journal of epidemiology., 38 (5). pp. 1272-1284.

Abstract

Background: Previous studies have assessed the relative importance of material, psychosocial and behavioural factors in the explanation of relative socio-economic inequalities in mortality, but research into the contribution of biomedical factors has been limited. Our study examines the relative contribution of (i) material, (ii) psychosocial, (iii) behavioural and (iv) biomedical factors in the explanation of relative socio-economic (educational and income) inequalities in mortality. Methods: Cohort study—baseline data from the Norwegian total county population-based HUNT 2 study linked to mortality data (1995/97 to 2003). In this analysis, 18 247 men and 18 278 women aged 24–80 without severe chronic disease at baseline were eligible. Results: No socio-economic inequalities in mortality among women were found. In men, educational- and income-related inequalities in mortality were found with a relative risk for the lowest educational group of 1.67 (1.29–2.15) and the lowest income quartile of 2.03 (1.57–2.70). Together, the four explanatory factors reduced the relative risk of mortality of the lowest educational group to 1.18 (0.90–1.55) and the relative risk of mortality in the lowest income quartile was attenuated to 1.17 (0.83–1.63). Known biomedical factors contributed least to both educational and income inequalities in mortality. Conclusions: Material factors were the most important in explaining income inequalities in mortality amongst men, whereas psychosocial and behavioural factors were the most important in explaining educational inequalities. This suggests that improving the material, psychosocial and behavioural circumstances of men might bring more substantial reductions in relative socio-economic inequalities in mortality.

Item Type:Article
Keywords:Socio-economic inequalities, Material factors, Psychosocial factors, Behavioural factors, Biomedical factors.
Full text:PDF - Accepted Version (309Kb)
Status:Peer-reviewed
Publisher Web site:http://dx.doi.org/10.1093/ije/dyp262
Publisher statement:This is a pre-copy-editing author-produced PDF of an article accepted for publication in International journal of epidemiology following peer review. The definitive publisher-authenticated version Skalická, V. and Lenthe, F. and Bambra, C. and Krokstad, S. and Mackenbach, J. (2009) 'Material, psychosocial, behavioural and biomedical factors in the explanation of socio-economic inequalities in mortality : evidence from the HUNT study.', International journal of epidemiology., 38 (5). pp. 1272-1284 is available online at: http://ije.oxfordjournals.org/cgi/content/abstract/38/5/1272
Record Created:19 Jan 2010 15:50
Last Modified:08 Dec 2011 09:41

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