SOCIAL-CLASS, HEALTH BEHAVIOR, AND MORTALITY AMONG MEN AND WOMEN IN EASTERN FINLAND
SOCIAL-CLASS, HEALTH BEHAVIOR, AND MORTALITY AMONG MEN AND WOMEN IN EASTERN FINLAND
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DOI：
10.1136/bmj.311.7005.589
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发表时间：
1995-09-02
影响因子：
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通讯作者：
NISSINEN, A
中科院分区：
文献类型：
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作者：
PEKKANEN, J;TUOMILEHTO, J;NISSINEN, A
目的 - 评估芬兰东部中年男性和女性中由职业、健康行为和全因死亡率定义的社会阶层与冠心病之间的关联。设计 - 对 1972 年和 1977 年检查的两个独立、随机人口样本进行前瞻性观察研究。地点 - 芬兰北卡累利阿和库奥皮奥。受试者 - 随访研究开始时年龄为 30-64 岁的 8967 名男性和 9694 名女性。通过使用国家死亡登记处对受试者的死亡率进行随访直至1987年。测量和主要结果——在随访期间共有1429名男性和620名女性死亡，其中603名男性和164名女性死于冠心病。在男女中，与白领工人相比，无技能的蓝领工人有更多的不利危险因素，并且因冠心病、其他心血管疾病、癌症、暴力原因和所有其他原因而导致的死亡率也更高。在男性中，当对吸烟、血清胆固醇浓度、高血压、体重指数和休闲时间的体力活动进行调整后，非熟练蓝领工人与白领工人的年龄调整后全因死亡相对风险从 1.85（95% 置信区间 1.55 至 2.22）降至 1.47（1.23 至 1.77）。在女性中，风险比相应从 1.49（1.15 至 1.92）降低至 1.39（1.07 至 1.81）。男性冠心病的危险比分别为1.54（1.16至2.02）和1.22（0.92至1.61），女性分别为1.74（1.05至2.90）和1.66（0.99至2.79）。结论——不利的心血管危险因素和高死亡率集中在芬兰的较低社会阶层。在男性中，大约一半的冠状动脉过多和全因死亡，非熟练蓝领工人的死亡率与其不利的危险因素有关。女性的关联较小。
Objective-To evaluate the associations between social class as defined by occupation, health behaviour, and mortality from all causes and coronary heart disease among middle aged men and women in eastern Finland.Design-Prospective observational study of two independent, random population samples examined in 1972 and 1977.Setting-North Karelia and Kuopio, Finland.Subjects-8967 men and 9694 women aged 30-64 years at the beginning of the follow up study. The subjects were followed up for mortality up till 1987 by using the National Death Registry.Measurements and main results-Altogether 1429 men and 620 women died during the follow up, 603 men and 164 women of coronary heart disease. Among both sexes, compared with white collar workers unskilled blue collar workers had more adverse risk factors and also higher mortality due to coronary heart disease, other cardiovascular diseases, cancer, violent causes, and all other causes. Among men the age adjusted relative risk for all cause mortality in unskilled blue collar workers v white collar workers was reduced from 1.85 (95% confidence interval 1.55 to 2.22) to 1.47 (1.23 to 1.77) when adjusted for smoking, serum cholesterol concentration, hypertension, body mass index, and physical activity in leisure time. Among women the corresponding reduction in hazard ratio was from 1.49 (1.15 to 1.92) to 1.39 (1.07 to 1.81). The respective hazard ratios for coronary heart disease were 1.54 (1.16 to 2.02) and 1.22 (0.92 to 1.61) among men and 1.74 (1.05 to 2.90) and 1.66 (0.99 to 2.79) among women.Conclusions-Unfavourable cardiovascular risk factors and high mortality are concentrated among lower social classes in Finland. Among men about half of the excess coronary and all cause,mortality among unskilled blue collar workers was associated with their unfavourable risk factor profile. The association was smaller in women.