title: Educational inequalities in blood pressure and cholesterol screening in nine European countries.
abstract: BACKGROUND
  To perform the first European overview of educational inequalities in the use of blood pressure and cholesterol screening.
  
  
  METHODS
  Data were obtained on the use of screening services according to educational level from nationally representative cross-sectional surveys in Belgium, Czech Republic, Denmark, Estonia, Finland, Hungary, Italy, Latvia and Lithuania. Screening rates were examined in the preceding 12 months and 5 years, for respondents 35+ years (45+ for women). ORs comparing low- to high-educated respondents were estimated using logistic regression controlling for age.
  
  
  RESULTS
  Inequalities in cholesterol screening favouring higher socioeconomic groups were demonstrated with statistical significance among men in four countries, whereby men with higher education were more likely to receive screening, with 1.22 as the highest OR. Among women, a similar pattern was found. Inequalities in blood pressure screening were even smaller and less often statistically significant. Hungary was the only country with higher rates of both types of screening in the low-educated group. In other countries, pro-high inequalities were slightly increased after controlling for self-rated health.
  
  
  CONCLUSIONS
  All European countries in this study had small educational inequalities in the utilisation of blood pressure and cholesterol screening. These inequalities are smaller than those previously observed in the USA. Further comparative studies need to distinguish between screening for preventive purposes and screening for treatment and control.
authors.affiliation: Department of Public Health, Erasmus Medical Centre, Rotterdam, the Netherlands. danielle.rodin@utoronto.ca
authors.forename: Danielle
authors.initials: D
authors.lastname: Rodin
authors.forename: Irina
authors.initials: I
authors.lastname: Stirbu
authors.forename: Ola
authors.initials: O
authors.lastname: Ekholm
authors.forename: Dagmar
authors.initials: D
authors.lastname: Dzurova
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Costa
authors.forename: Johan P
authors.initials: JP
authors.lastname: Mackenbach
authors.forename: Anton E
authors.initials: AE
authors.lastname: Kunst
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000517:prevention & control; D002784:Cholesterol / Q000097:blood*; D003430:Cross-Sectional Studies; D004522:Educational Status; D005060:Europe; D005260:Female; D019538:Health Care Surveys; D006301:Health Services Needs and Demand; D006302:Health Services Research; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011314:Preventive Health Services / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D002784:Cholesterol