title: Occupational class and ischemic heart disease mortality in the United States and 11 European countries.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Public Health, Erasmus University, Rotterdam, The Netherlands. kunst@mgz.fgg.eur.nl
authors.forename: A E
authors.initials: AE
authors.lastname: Kunst
authors.forename: F
authors.initials: F
authors.lastname: Groenhof
authors.forename: O
authors.initials: O
authors.lastname: Andersen
authors.forename: J K
authors.initials: JK
authors.lastname: Borgan
authors.forename: G
authors.initials: G
authors.lastname: Costa
authors.forename: G
authors.initials: G
authors.lastname: Desplanques
authors.forename: H
authors.initials: H
authors.lastname: Filakti
authors.forename: M do R
authors.initials: Mdo R
authors.lastname: Giraldes
authors.forename: F
authors.initials: F
authors.lastname: Faggiano
authors.forename: S
authors.initials: S
authors.lastname: Harding
authors.forename: C
authors.initials: C
authors.lastname: Junker
authors.forename: P
authors.initials: P
authors.lastname: Martikainen
authors.forename: C
authors.initials: C
authors.lastname: Minder
authors.forename: B
authors.initials: B
authors.lastname: Nolan
authors.forename: F
authors.initials: F
authors.lastname: Pagnanelli
authors.forename: E
authors.initials: E
authors.lastname: Regidor
authors.forename: D
authors.initials: D
authors.lastname: Vågerö
authors.forename: T
authors.initials: T
authors.lastname: Valkonen
authors.forename: J P
authors.initials: JP
authors.lastname: Mackenbach
mesh_terms: D000328:Adult; D017677:Age Distribution; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D005060:Europe / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000209:etiology / Q000401:mortality*; D009790:Occupations / Q000145:classification*; D011159:Population Surveillance; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology