title: The contribution of housing and neighbourhood conditions to educational inequalities in non-communicable diseases in Europe: findings from the European Social Survey (2014) special module on the social determinants of health.
abstract: Social gradients have been found across European populations, where less affluent groups are more often affected by poor housing and neighbourhood conditions. While poor housing and neighbourhood quality have been associated with a range of non-communicable diseases (NCDs), these conditions have rarely been applied to the examination of socioeconomic differences in NCDs. This study therefore asks ‘to what extent does adjusting for poor housing and neighbourhood conditions reduce inequalities in NCDs among men and women in Europe’?
  
  
  
  Our analysis used pooled-data from 20 European countries for women (n= 12 794) and men (n= 11 974), aged 25–75, from round 7 of the European Social Survey. Fourteen NCDs were investigated: heart/circulatory problems, high blood pressure, back pain, arm/hand pain, foot/leg pain, allergies, breathing problems, stomach/digestion problems, skin conditions, diabetes, severe headaches, cancer, obesity and depression. We used binary logistic regression models, stratified by gender, and adjusted rate ratios to examine whether educational inequalities in NCDs were reduced after controlling for poor housing and neighbourhood quality.
  
  
  
  Overall, we find that adjusting for poor housing and neighbourhood quality reduces inequalities in NCDs. While reductions were relatively small for some NCDs–for high blood pressure, reductions were found in the range of 0–4.27% among women—for other conditions reductions were more considerable. Controlling for both housing and neighbourhood conditions for example, reduced inequalities by 16–24% for severe headaches and 14–30% for breathing problems.
  
  
  
  Social gradients in poor housing and neighbourhood quality could be an important contributor to educational inequalities in some NCDs.
authors.affiliation: Department of Sociology and Political Science, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Courtney L
authors.initials: CL
authors.lastname: McNamara
authors.affiliation: Department of Sociology and Political Science, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Mirza
authors.initials: M
authors.lastname: Balaj
authors.affiliation: Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, UK.
authors.forename: Katie H
authors.initials: KH
authors.lastname: Thomson
authors.affiliation: Department of Sociology and Political Science, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Terje A
authors.initials: TA
authors.lastname: Eikemo
authors.affiliation: Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, UK.
authors.forename: Clare
authors.initials: C
authors.lastname: Bambra
mesh_terms: D000328:Adult; D000368:Aged; D004522:Educational Status; D005060:Europe / Q000453:epidemiology; D005260:Female; D006798:Housing / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000073296:Noncommunicable Diseases / Q000453:epidemiology*; D011203:Poverty; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012923:Social Class; D064890:Social Determinants of Health / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires