Social inequalities and mortality in Europe--results from a large multi-national cohort.
Social inequalities and mortality in Europe--results from a large multi-national cohort.
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DOI：
10.1371/journal.pone.0039013
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Vineis P
中科院分区：
文献类型：
--
作者：
Gallo V;Mackenbach JP;Ezzati M;Menvielle G;Kunst AE;Rohrmann S;Kaaks R;Teucher B;Boeing H;Bergmann MM;Tjønneland A;Dalton SO;Overvad K;Redondo ML;Agudo A;Daponte A;Arriola L;Navarro C;Gurrea AB;Khaw KT;Wareham N;Key T;Naska A;Trichopoulou A;Trichopoulos D;Masala G;Panico S;Contiero P;Tumino R;Bueno-de-Mesquita HB;Siersema PD;Peeters PP;Zackrisson S;Almquist M;Eriksson S;Hallmans G;Skeie G;Braaten T;Lund E;Illner AK;Mouw T;Riboli E;Vineis P
在北美和欧洲，国家一级的死亡率都存在社会经济不平等。这项工作的目的是调查的贡献，具体的风险因素的社会不平等的原因，具体的死亡率使用一个大型多国队列的欧洲人。对欧洲癌症与营养前瞻性调查（EPIC）的3，456，689人/年随访进行了分析。来自9个欧洲国家的受试者的教育水平被记录为社会经济地位（SES）的代理。逐步纳入解释变量的考克斯比例风险模型用于探讨SES与死亡率之间的关系;计算相对不平等指数（RII）作为相对不平等的度量。受教育程度最高的男性总死亡率比受教育程度最低的男性低43%（HR 0.57，95% CI）。0.52-0.61）;妇女中为29%（HR 0.71，95% C.I. 0.64-0.78）。通过引入吸烟，男性和女性的风险降低分别降低了7%和3%，通过引入体重指数和其他解释变量（酒精消费、休闲体育活动、水果和蔬菜摄入）（男性为3%，女性为5%），风险降低程度较小（男性为2%，女性为3%）。社会不平等在统计上对男性的所有死亡原因都有很大影响。在妇女中，社会不平等不那么严重，但在所有死亡原因中，除癌症相关死亡和伤害外，社会不平等具有统计意义。在这项欧洲研究中，报告了欧洲男性和女性死亡率的巨大社会不平等，这不能通过考虑已知的慢性病常见风险因素来完全解释。
Socio-economic inequalities in mortality are observed at the country level in both North America and Europe. The purpose of this work is to investigate the contribution of specific risk factors to social inequalities in cause-specific mortality using a large multi-country cohort of Europeans. A total of 3,456,689 person/years follow-up of the European Prospective Investigation into Cancer and Nutrition (EPIC) was analysed. Educational level of subjects coming from 9 European countries was recorded as proxy for socio-economic status (SES). Cox proportional hazard model's with a step-wise inclusion of explanatory variables were used to explore the association between SES and mortality; a Relative Index of Inequality (RII) was calculated as measure of relative inequality. Total mortality among men with the highest education level is reduced by 43% compared to men with the lowest (HR 0.57, 95% C.I. 0.52–0.61); among women by 29% (HR 0.71, 95% C.I. 0.64–0.78). The risk reduction was attenuated by 7% in men and 3% in women by the introduction of smoking and to a lesser extent (2% in men and 3% in women) by introducing body mass index and additional explanatory variables (alcohol consumption, leisure physical activity, fruit and vegetable intake) (3% in men and 5% in women). Social inequalities were highly statistically significant for all causes of death examined in men. In women, social inequalities were less strong, but statistically significant for all causes of death except for cancer-related mortality and injuries. In this European study, substantial social inequalities in mortality among European men and women which cannot be fully explained away by accounting for known common risk factors for chronic diseases are reported.
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影响因子：
105.7
作者：
Hart, Carole L.;Gruer, Laurence;Watt, Graham C. M.
通讯作者：
Watt, Graham C. M.
影响因子：
4.7
作者：
Slimani, N;Ferrari, P;Riboli, E
通讯作者：
Riboli, E
影响因子：
5.6
作者：
Karlamangla, Arun S.;Merkin, Sharon Stein;Seeman, Teresa E.
通讯作者：
Seeman, Teresa E.
影响因子：
5
作者：
Din-Dzietham, R;Liao, DP;Tyroler, HA
通讯作者：
Tyroler, HA
影响因子：
3.2
作者：
Riboli, E;Hunt, KJ;Saracci, R
通讯作者：
Saracci, R