Occupational class and ischemic heart disease mortality in the United States and 11 European countries
Occupational class and ischemic heart disease mortality in the United States and 11 European countries
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DOI：
10.2105/ajph.89.1.47
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发表时间：
1999-01-01
影响因子：
12.7
通讯作者：
Mackenbach, JP
中科院分区：
文献类型：
--
作者：
Kunst, AE;Groenhof, F;Mackenbach, JP
目标。对十二个国家的缺血性心脏病死亡率的职业类别差异进行了比较，以确定与较小或较大死亡率差异相关的因素。方法。 30 至 64 岁男性按职业类别划分的死亡率数据来自 20 世纪 80 年代的全国纵向或横断面研究。大多数国家都采用共同的职业类别计划。对主要数据问题的潜在影响进行了定量评估。结果。欧洲内部存在着南北对比。在英格兰和威尔士、爱尔兰和北欧国家，体力劳动者的死亡率高于非体力劳动者。在法国、瑞士和地中海国家，体力劳动者的死亡率与非体力劳动者一样低，甚至更低。与北欧相比，美国的死亡率差异较小（30-44 岁男性）或大致相同（45-64 岁男性）。结论。结果强调了缺血性心脏病死亡率中社会经济不平等的高度可变性。这些不平等似乎对行为风险因素的社会梯度高度敏感。这些风险因素梯度是由文化和社会经济发展决定的。
Objectives. Twelve countries were compared with respect to occupational class differences in ischemic heart disease mortality in order to identify factors that are associated with smaller or larger mortality differences.Methods. Data on mortality by occupational class among men aged 30 to 64 years were obtained from national longitudinal or cross-sectional studies for the 1980s. A common occupational class scheme was applied to most countries. Potential effects of the main data problems were evaluated quantitatively.Results. A north-south contrast existed within Europe. In England and Wales, Ireland, and Nordic countries, manual classes had higher mortality rates than nonmanual classes. In France, Switzerland, and Mediterranean countries, manual classes had mortality rates as low as, or lower than, those among nonmanual classes. Compared with Northern Europe, mortality differences in the United States were smaller (among men aged 30-44 years) or about as large (among men aged 45-64 years).Conclusions. The results underline the highly variable nature of socioeconomic inequalities in ischemic heart disease mortality. These inequalities appear to be highly sensitive to social gradients in behavioral risk factors. These risk factor gradients are determined by cultural as well as socioeconomic developments.