Structural changes and social inequalities in health in Finland, 1986-1994.
BACKGROUND
This paper seeks to examine changes in health inequalities in Finland from the mid-1980s to the mid-1990s. To improve our understanding of the contribution of employment status changes to class and educational differences in health within the context of changing labour market conditions, we examined the differences in ill health among social classes, educational groups, and employment status groups.


METHODS
The data was derived from nation-wide Finnish Surveys on Living Conditions from 1986 and 1994. Analyses included the age range 25-64 years. Health was measured using limiting long-standing illness and perceived health as below good. Results are presented as age-standardized prevalence percentages and odds ratios from logistic regression analyses.


RESULTS
The pattern and size of relative social inequalities in ill health have remained generally stable during the eight-year study period in Finland. Differences between social classes have changed only slightly. Differences between educational groups have declined somewhat among men, but have remained stable among women. Compared with the employed, health among the unemployed, housewives, and pensioners has improved for both men and women. Analysing social class differences within both the employed and the non-employed showed only negligible changes.


CONCLUSIONS
Changes in social inequalities in health as indicated by class and educational differentials among Finnish men and women have mostly been negligible. The observed changes are likely to have been affected by the 1990s' labour market crisis in Finland. The rapidly increasing mass unemployment is unlikely to have been very individually selective in the short run. However, in the longer run, to the extent that unemployment remains high, this trend can be expected to change as re-entry to paid employment is likely to be more individually selective.
Manderbacka
K
K
National Research and Development, Centre for Welfare and Health, Health Services Research, and Department of Public Health, University of Helsinki, Finland. kristiina.manderbacka@stakes.fi
Lahelma
E
E
Rahkonen
O
O
D000328:Adult; D002908:Chronic Disease / Q000453:epidemiology; D004522:Educational Status; D004651:Employment / Q000706:statistics & numerical data / Q000639:trends; D005260:Female; D005387:Finland / Q000453:epidemiology; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010465:Perception; D015995:Prevalence; D012647:Self-Assessment; D012922:Social Change; D012923:Social Class; D012946:Social Welfare / Q000191:economics / Q000639:trends*; D012959:Socioeconomic Factors