[Socioeconomic circumstances and premature mortality from chronic diseases].
OBJECTIVE
Our aim was to investigate the association between socioeconomic factors in childhood or adolescence and adulthood and premature mortality from various causes of death.


METHODS
Men and women aged 25-74 years residing on May 1, 1996, in the Autonomous Community of Madrid. For the next 19 months, information on individuals who died and the cause of death were obtained from the Mortality Register. We estimated the mortality from 5 types of cancer and from 4 chronic diseases by the educational level--as an indicator of the socioeconomic circumstances in childhood or adolescence--and by income--as an indicator of the socioeconomic circumstances in adulthood.


RESULTS
When both variables were included in the analysis simultaneously, the relative mortality ratio for men with second grade first phase and lower educational level versus those with second grade, second phase and higher educational level and the relative mortality ratio for men belonging to income quartiles 3 and 4 (lowest) versus those belonging to quartiles 1 and 2 were, respectively: 1.15 (95% confidence interval 1.01-1.31) and 1.22 (1.09-1.36) for lung cancer; 1.46 (1.19-1,93) and 1.13 (0.90-1.41) for gastric cancer; 1.80 (1.32-2.44) and 1.46 (1.18-1.80) for chronic obstructive pulmonary disease; and 1.18 (0.77-1.81) and 0.68 (0.47-0.98) for diabetes mellitus. For women the relative mortality ratios were, respectively: 0.63 (0.43-0.92) and 0.72 (0.52-0.99) for lung cancer; 1.68 (0.99-2.83) and 1.17 (0.86-1.60) for gastric cancer; 0.76 (0.61-0.94) and 0.98 (0.82-1.16) for breast cancer; 1.36 (0.95-1.95) and 1.20 (0.97-1.48) for ischemic heart disease; 1.72 (1.19-2.50) and 0.93 (0.75-1.16) for stroke; and 2.23 (0.94-5.27) and 1.51 (1.02-2.25) for diabetes mellitus.


CONCLUSIONS
Premature mortality in adulthood is associated with several socioeconomic factors acting across the whole course of life. The contribution of these socioeconomic circumstances to mortality varies regarding the cause of death and gender.
Regidor
Enrique
E
Departamento de Medicina Preventiva, Salud Pública e Historia de la Ciencia. Universidad Complutense de Madrid. España.
Domínguez
Vicente
V
Calle
M Elisa
ME
Navarro
Pedro
P
D000328:Adult; D000367:Age Factors; D000368:Aged; D002423:Cause of Death; D002908:Chronic Disease / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology