Socioeconomic differences in the prevalence of common chronic diseases: an overview of eight European countries
Socioeconomic differences in the prevalence of common chronic diseases: an overview of eight European countries
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DOI：
10.1093/ije/dyh386
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发表时间：
2005-04-01
影响因子：
7.7
通讯作者：
Mackenbach, JP
中科院分区：
文献类型：
--
作者：
Dalstra, JAA;Kunst, AE;Mackenbach, JP
背景：很少有研究比较社会经济不平等对致命性和非致命性疾病患病率的影响。本文旨在对几种常见的慢性疾病进行首次国际综述。方法收集20世纪90年代在欧洲8个国家进行的非标准化国民健康调查的微观数据。调查的参与人数从3700人到4200人不等。分析了17个慢性疾病群体的患病率与教育程度的关系。计算标准化患病率和年龄调整优势比（ORs）。结果多数疾病在低学历人群中患病率较高。中风、神经系统疾病、糖尿病和关节炎表现出相对较大的不平等（OR 1.50）。在癌症、肾脏疾病和皮肤病方面，没有明显的社会经济差异。过敏在受过高等教育的人群中很常见。与25-59岁年龄组相比，60-79岁年龄组的相对社会经济差异往往较小。癌症在25-59岁受教育程度较低的人群中更为普遍，但在60-79岁受教育程度较高的人群中更为普遍。对于糖尿病、高血压和心脏病，女性的社会经济差异比男性更大。与南欧国家相比，北欧国家在心脏病方面的不平等更大。结论慢性疾病患病率社会经济差异的大小和模式存在较大差异。在相同的特定致命疾病（如中风）和新致命疾病（如关节炎）中发现的巨大不平等需要在面向公平的研究和政策中特别注意。
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 snore 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 same specific fatal diseases (e.g. stroke) and noel-fatal diseases (e.g. arthritis) require special attention in equity-oriented research and policies.