Occupational class and cause specific mortality in middle aged men in 11 European countries: comparison of population based studies. EU Working Group on Socioeconomic Inequalities in Health.
OBJECTIVE
To compare countries in western Europe with respect to class differences in mortality from specific causes of death and to assess the contributions these causes make to class differences in total mortality.


METHODS
Comparison of cause of death in manual and non-manual classes, using data on mortality from national studies.


METHODS
Eleven western European countries in the period 1980-9.


METHODS
Men aged 45-59 years at death.


RESULTS
A north-south gradient was observed: mortality from ischaemic heart disease was strongly related to occupational class in England and Wales, Ireland, Finland, Sweden, Norway, and Denmark, but not in France, Switzerland, and Mediterranean countries. In the latter countries, cancers other than lung cancer and gastrointestinal diseases made a large contribution to class differences in total mortality. Inequalities in lung cancer, cerebrovascular disease, and external causes of death also varied greatly between countries.


CONCLUSIONS
These variations in cause specific mortality indicate large differences between countries in the contribution that disease specific risk factors like smoking and alcohol consumption make to socioeconomic inequalities in mortality. The mortality advantage of people in higher occupational classes is independent of the precise diseases and risk factors involved.
Kunst
A E
AE
Department of Public Health, Erasmus University, PO Box 1738, NL-3000 DR Rotterdam, Netherlands. kunst@mgz.fgg.eur.nl
Groenhof
F
F
Mackenbach
J P
JP
Health
E W
EW
D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D002561:Cerebrovascular Disorders / Q000401:mortality; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005767:Gastrointestinal Diseases / Q000401:mortality; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000401:mortality; D009369:Neoplasms / Q000401:mortality; D009790:Occupations / Q000145:classification*; D012120:Respiration Disorders / Q000401:mortality; D012923:Social Class; D012959:Socioeconomic Factors