Socioeconomic differences in the prevalence of common chronic diseases: an overview of eight European countries.
BACKGROUND
Few studies have compared socioeconomic inequalities in the prevalence of both fatal and non-fatal diseases. This paper aims to give the first international overview for several common chronic diseases.


METHODS
Micro-level data were pooled from non-standardized national health surveys conducted in eight European countries in the 1990s. Surveys ranged in size from 3700 to 41 200 participants. The prevalence of 17 chronic disease groups were analysed in relation to education. Standardized prevalence rates and age-adjusted odds ratios (ORs) were calculated.


RESULTS
Most diseases showed higher prevalence among the lower education group. Stroke, diseases of the nervous system, diabetes, and arthritis displayed relatively large inequalities (OR > 1.50). No socioeconomic differences were evident for cancer, kidney diseases, and skin diseases. Allergy was more common in the higher education group. Relative socioeconomic differences were often smaller among the 60-79 age group as compared with the 25-59 age group. Cancer was more prevalent among the lower educated in the 25-59 age group, but among the higher educated in the 60-79 age group. For diabetes, hypertension, and heart disease, socioeconomic differences were larger among women as compared with men. Inequalities in heart disease were larger in northern European countries as compared with southern European countries.


CONCLUSIONS
There are large variations between chronic diseases in the size and pattern of socioeconomic differences in their prevalence. The large inequalities that are found for some specific fatal diseases (e.g. stroke) and non-fatal diseases (e.g. arthritis) require special attention in equity-oriented research and policies.
Dalstra
J A A
JA
Department of Public Health, Erasmus MC, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. j.dalstra@erasmusmc.nl
Kunst
A E
AE
Borrell
C
C
Breeze
E
E
Cambois
E
E
Costa
G
G
Geurts
J J M
JJ
Lahelma
E
E
Van Oyen
H
H
Rasmussen
N K
NK
Regidor
E
E
Spadea
T
T
Mackenbach
J P
JP
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001249:Asthma / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012959:Socioeconomic Factors