title: Trends in socioeconomic inequalities in self-assessed health in 17 European countries between 1990 and 2010.
abstract: Between the 1990s and 2000s, relative inequalities in all-cause mortality increased, whereas absolute inequalities decreased in many European countries. Whether similar trends can be observed for inequalities in other health outcomes is unknown. This paper aims to provide a comprehensive overview of trends in socioeconomic inequalities in self-assessed health (SAH) in Europe between 1990 and 2010.
  
  
  
  Data were obtained from nationally representative surveys from 17 European countries for the various years between 1990 and 2010. The age-standardised prevalence of less-than-good SAH was analysed by education and occupation among men and women aged 30-79 years. Socioeconomic inequalities were measured by means of absolute rate differences and relative rate ratios. Meta-analysis with random-effects models was used to examine the trends of inequalities.
  
  
  
  We observed declining trends in the prevalence of less-than-good SAH in many countries, particularly in Southern and Eastern Europe and the Baltic states. In all countries, less-than-good SAH was more prevalent in lower educational and manual groups. For all countries together, absolute inequalities in SAH were mostly constant, whereas relative inequalities increased. Almost no country consistently experienced a significant decline in either absolute or relative inequalities.
  
  
  
  Trends in inequalities in SAH in Europe were generally less favourable than those found for inequalities in mortality, and there was generally no correspondence between the two when we compared the trends within countries. In order to develop policies or interventions that effectively reduce inequalities in SAH, a better understanding of the causes of these inequalities is needed.
authors.affiliation: Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Yannan
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: van Lenthe
authors.affiliation: Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Borsboom
authors.affiliation: Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Caspar W N
authors.initials: CW
authors.lastname: Looman
authors.affiliation: Institute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Bopp
authors.affiliation: Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Bo
authors.initials: B
authors.lastname: Burström
authors.affiliation: Department of Social Geography and Regional Development, Faculty of Science, Charles University in Prague, Prague, Czech Republic.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Dzúrová
authors.affiliation: National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
authors.forename: Ola
authors.initials: O
authors.lastname: Ekholm
authors.affiliation: Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Jurate
authors.initials: J
authors.lastname: Klumbiene
authors.affiliation: Department of Public Health, University of Helsinki, Helsinki, Finland.
authors.forename: Eero
authors.initials: E
authors.lastname: Lahelma
authors.affiliation: Stockholm Centre on Health of Societies in Transition, Södertörn University, Huddinge, Sweden Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia.
authors.forename: Mall
authors.initials: M
authors.lastname: Leinsalu
authors.affiliation: Department of Preventive Medicine and Public Health, Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Regidor
authors.affiliation: Departamento de Geografia, Centro de Estudos de Geografia e de Ordenamento do Territorio (CEGOT), Colégio de S. Jerónimo, Universidade de Coimbra, Coimbra, Portugal.
authors.forename: Paula
authors.initials: P
authors.lastname: Santana
authors.affiliation: Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Rianne
authors.initials: R
authors.lastname: de Gelder
authors.affiliation: Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Johan P
authors.initials: JP
authors.lastname: Mackenbach
mesh_terms: D000328:Adult; D000368:Aged; D001454:Baltic States; D004522:Educational Status; D005060:Europe; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D009790:Occupations; D015995:Prevalence; D012959:Socioeconomic Factors
keywords: Health inequalities; SELF-RATED HEALTH; SOCIAL EPIDEMIOLOGY